信息共享的平等主义视角:以医疗保健优先事项为例

IF 1.8 3区 哲学 Q2 ETHICS Health Care Analysis Pub Date : 2023-12-30 DOI:10.1007/s10728-023-00475-7
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引用次数: 0

摘要

摘要 在医疗保健领域,向患者提供相关信息不仅是一项道德要求,也是一项法律义务,通常是通过获得知情同意的角度来阐述的。医学伦理守则和许多国家的法律都规定,必须披露有关诊断、预后和治疗方案的基本信息。然而,在政府资助的医疗系统中,其他类型的信息对病人来说也可能是重要的,比如对所提供的治疗方案所依据的医疗优先事项的深入了解。虽然传统观点并不把这些信息视为必须与患者共享的信息,也许是认为这些信息在临床上是 "不可操作的",但我们主张进行模式转变。我们的主张与强调可操作性的传统观点不同。我们认为,尊重患者作为平等的道德主体,除其他原则外,还必须承诺诚实。隐瞒与患者理解自身情况相关的特定类别信息本质上不符合这一原则。在本文中,我们主张重新调整举证责任。我们建议,医生不需要为增加标准信息项目提供特殊理由,而是应该能够为排除与患者情况相关的事实以及影响医护人员选择的基本考虑因素提供正当理由。这种观点将透明度放在首位,使患者能够全面了解情况,符合尊重患者人格的精神。
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An Egalitarian Perspective on Information Sharing: The Example of Health Care Priorities

Abstract

In health care, the provision of pertinent information to patients is not just a moral imperative but also a legal obligation, often articulated through the lens of obtaining informed consent. Codes of medical ethics and many national laws mandate the disclosure of basic information about diagnosis, prognosis, and treatment alternatives. However, within publicly funded health care systems, other kinds of information might also be important to patients, such as insights into the health care priorities that underlie treatment offers made. While conventional perspectives do not take this as an obligatory part of the information to be shared with patients, perhaps through viewing it as clinically “non-actionable,” we advocate for a paradigm shift. Our proposition diverges from the traditional emphasis on actionability. We contend that honoring patients as equal moral agents necessitates, among other principles, a commitment to honesty. Withholding specific categories of information pertinent to patients’ comprehension of their situation is inherently incompatible with this principle. In this article, we advocate for a recalibration of the burden of proof. Rather than requiring special justifications for adding to the standard set of information items, we suggest that physicians should be able to justify excluding relevant facts about the patient’s situation and the underlying considerations shaping health care professionals’ choices. This perspective prioritizes transparency and empowers patients with a comprehensive understanding, aligning with the ethos of respect for the patient as person.

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来源期刊
CiteScore
4.20
自引率
0.00%
发文量
3
期刊介绍: Health Care Analysis is a journal that promotes dialogue and debate about conceptual and normative issues related to health and health care, including health systems, healthcare provision, health law, public policy and health, professional health practice, health services organization and decision-making, and health-related education at all levels of clinical medicine, public health and global health. Health Care Analysis seeks to support the conversation between philosophy and policy, in particular illustrating the importance of conceptual and normative analysis to health policy, practice and research. As such, papers accepted for publication are likely to analyse philosophical questions related to health, health care or health policy that focus on one or more of the following: aims or ends, theories, frameworks, concepts, principles, values or ideology. All styles of theoretical analysis are welcome providing that they illuminate conceptual or normative issues and encourage debate between those interested in health, philosophy and policy. Papers must be rigorous, but should strive for accessibility – with care being taken to ensure that their arguments and implications are plain to a broad academic and international audience. In addition to purely theoretical papers, papers grounded in empirical research or case-studies are very welcome so long as they explore the conceptual or normative implications of such work. Authors are encouraged, where possible, to have regard to the social contexts of the issues they are discussing, and all authors should ensure that they indicate the ‘real world’ implications of their work. Health Care Analysis publishes contributions from philosophers, lawyers, social scientists, healthcare educators, healthcare professionals and administrators, and other health-related academics and policy analysts.
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