应用新医疗技术的伦理。

Kenneth V Iserson, Patrick M Chiasson
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引用次数: 9

摘要

医疗技术本身,包括微创手术,是没有道德的;我们的道德围绕着我们何时以及如何使用技术。这通常涉及到临床医生个人对自身能力的评估,以及对该技术两个方面的认识:已证实的有效性和安全性。技术正在超越知识吗?还是说,医生采用新技术是出于良好的动机和负责任的态度?没有人确切知道。医学技术的进步好坏参半。在使用由医疗从业人员个人控制的新技术时,唯一涉及的伦理因素是用户对设备、程序或药物的熟练程度,以及他们在征得患者同意使用这些技术时向患者提供的相关信息。新技术可分为两大类:最常见的渐进式技术和偶尔出现的革命性技术,它们可能会彻底改变医疗保健的面貌。所有新技术的学习曲线都是陡峭的。那么,什么时候应该允许医生在没有监督的情况下使用这些新技术呢?谁负责制定和监督新技术的标准?随着医疗技术创新的目标不断变化,个体从业者主要负责合乎道德地使用新技术(对他们来说)。医生的道德规范控制着他们对新技术的使用,确保他们有必要的培训和经验来使用这种方式,并且干预对他们的病人是安全的。地方一级的机构从业人员资格证书,尽管存在缺陷,但往往是对技术使用的主要控制。最终决定新技术使用的是医疗机构和个人从业人员的道德规范(如果存在的话),以及患者的需求。这就是为什么道德教育对医生、其他健康从业者和医疗管理人员至关重要的另一个原因。
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The ethics of applying new medical technologies.

Medical technology itself, including minimally invasive surgery, has no morals; our morality revolves around when and how we use technology. This often involves the individual clinician's assessment of their own abilities and an awareness of two aspects of the technology: its proven efficacy and its safety. Is technology outpacing knowledge? Or do physicians adopt new technologies in a responsible way with good motives? No one knows for sure. Technological progress in medicine has been a mixed blessing. The only ethical element involved in the use of new technologies over which individual medical practitioners have control, is that of user proficiency with the device, procedure, or drug, and the related information they provide to their patients when obtaining their consent for its use. New technologies fall into two broad categories: evolutionary, the most common, and revolutionary, which occur sporadically and may completely change the face of medical care. The learning curve for all new technologies can be steep. So, when should physicians be permitted to use these new technologies without supervision? Who is responsible for setting and monitoring standards for new technologies? With the moving target of medical technological innovation, individual practitioners are primarily responsible for the ethical use of new (to them) technologies. It is physicians' ethics that govern their use of new technologies, being certain that they have the requisite training and experience to use the modality, and that the intervention is safe for their patients. Institutional practitioner credentialing at the local level, despite its faults, will often be the primary control over a technology's use. What will ultimately govern the use of new technologies is the ethics (if they exist) of healthcare institutions and individual practitioners, as well as patient need. This is simply another reason why ethics education is vital for physicians-and other health practitioners and healthcare administrators.

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