Refusing to treat – is it legal? Is it justifiable? Is it ethical?

L. Sykes, Albert M van Zyl, Angela M Harris
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Abstract

Historically, when clinicians wanted to know if certain conduct was ethical, they would consult the guidelines set out in the Hippocratic oath. While adherence to the oath may “represent an expression of the professions’ ethical obligations”, and be useful in promoting their commitment to “abide by these norms”, this assumption is open to question.1 Different practitioners may see and interpret the codes in different ways, depending on their personal ethos as well as the specific time and situation under consideration. At the same time, ethical material can and should reform, and when needed, be re written under optimal cool, calm conditions. Changes should be based on “contributions from those with a variety of perspectives who have access to as much available knowledge as possible” and not implemented as a result of immediate pressures where there may be distorting circumstances.1 Perhaps the best way to judge their value is to debate how well the code addresses the issue at hand in terms of its “comprehensiveness, clarity and consistency”.1 This paper uses an actual patient scenario as a basis on which to pose some clinically and ethically related queries and postulate possible solutions.
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拒绝治疗——合法吗?这是合理的吗?这合乎道德吗?
从历史上看,当临床医生想知道某些行为是否合乎道德时,他们会参考希波克拉底誓言中规定的指南。虽然遵守誓言可能“代表了职业道德义务的表达”,并有助于促进他们“遵守这些规范”的承诺,但这一假设值得商榷。1不同的从业者可能会根据他们的个人精神以及所考虑的具体时间和情况,以不同的方式看待和解释准则。与此同时,伦理材料可以也应该进行改革,并在需要时,在最佳的凉爽、平静的条件下重写。变革应该基于“那些有各种观点、能够获得尽可能多可用知识的人的贡献”,而不是由于可能存在扭曲情况的直接压力而实施的“全面性、清晰性和一致性”。1本文以实际的患者场景为基础,提出一些与临床和伦理相关的问题,并提出可能的解决方案。
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