当前产科实践中的伦理困境及解决建议

E. Howe
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摘要

随着产科出现新的伦理难题,自从罗伊诉韦德案被推翻以来,医疗服务提供者面临着越来越多的挑战,他们必须知道解决这些问题的最佳方法。新的伦理挑战已经出现,例如,当病人需要前往另一个州堕胎时,临床医生应该如何应对。第二个说明性的例子涉及未成年人。在美国的一些州,这些患者可以合法地向法官申请堕胎许可,而不必告诉父母。如果这些青少年不知道这一点,提供者必须决定他们是否应该主动告知他们这种可能性,如果是,何时告知。当这些病人也生活在一个不允许他们选择堕胎的州时,这个问题就更具挑战性了。供应商面临的道德问题,如上述可能难以确定如何最好地解决这些困境。这篇文章将回顾一些关键的,特别是更微妙的,道德的方法,供应商可能面临更好地解决这些问题。首先,我将强调解决供应商可能不知道或可能忽视的道德结果的方法。这些将包括提供者如何最好地应用核心伦理原则和附加的辅助框架,即护理观点或护理伦理。我将提供具体的示例来说明每一个
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Current ethical dilemmas in obstetrical practice and some suggestions regarding how to resolve them
As new ethical conundrums arise in obstetrics, providers are ever-increasingly challenged with having to know the best means of resolving these problems since Roe v. Wade was overturned. New ethical challenges have arisen, for example, as to how clinicians should respond when patients would need to travel to another state to get an abortion. A second illustrative example involves minors. In some states in the U.S., these patients legally can request permission from a judge to have an abortion without their having to tell their parents. If these adolescents don’t know this, providers must decide whether they should take initiative to inform them of this possibility and if so, when. This question is still more challenging when these patients, too, live in a state that does not allow them the option of abortion. Providers confronted with ethical problems such as those above may struggle to determine how to best resolve these dilemmas. This piece will review some key and especially more subtle, ethical approaches that providers may face to better resolve them. Initially, I will highlight approaches to resolving ethical outcomes that providers may not know or may overlook. These will include how providers may best apply both core ethical principles and an additional, adjunctive framework, known as the care perspective or ethics of care. I will provide specific examples to illustrate each
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