CAJ | 학술논문

医学临床实践中,无自主能力患者代理人的决定有时会和患者利益产生矛盾冲突.作者归类总结了医生面临的这些两难问题,并以分析具体案例为基础,提出了解决相关问题的伦理原则.医生应该充分尊重患者代理人的理性决定,而理性决定的前提条件应该是代理人在对疾病信息、治疗手段和预后等情况充分认知的情况下,以不伤害被代理患者的利益为出发点,做出的有利于其生命健康利益的医学选择.而这一理性选择既不得违背国家法律,更不能出于患者利益考虑而侵犯到他人、集体和社会利益,并应符合公正分配卫生资源的医学伦理精神.
의학림상실천중,무자주능력환자대리인적결정유시회화환자이익산생모순충돌.작자귀류총결료의생면림적저사량난문제,병이분석구체안례위기출,제출료해결상관문제적윤리원칙.의생응해충분존중환자대리인적이성결정,이이성결정적전제조건응해시대리인재대질병신식、치료수단화예후등정황충분인지적정황하,이불상해피대리환자적이익위출발점,주출적유리우기생명건강이익적의학선택.이저일이성선택기불득위배국가법률,경불능출우환자이익고필이침범도타인、집체화사회이익,병응부합공정분배위생자원적의학윤리정신.
It is found in clinical practice that decisions made by agents on hehalf of the patients without capability of independent choice may sometimes conflict interests of the patient in question. The author summarized by categories common dilemmas faced by clinicians, and came up with the ethical principles to resolve the problems, as proven in case studies. Doctors should fully respect reasonable decisions of agents of such patients. Furthermore, to make a reasonable decision on their behalf, the agent is expected to make medical decisions in the interests of the life and health of the patient, with adequate knowledge of the disease, therapeutic measures and outcomes, and without any damage to interests of the patient they represent. Such a reasonable decision should neither violate laws of the state, nor infringe on interests of other individuals, collectives and the society at large for benefits of the patient in question. In addition, it should conform to the medical ethics of fair distribution of health resources.