临床医学伦理.PPT

Patient’s perspective Both medical and personal considerations seem to play a role in the patient’s decision, but personal values and experiences predominate Side effects of chemotherapy would prevent them from carrying out these activities Meaning of their life would be gone and quality of life decreased Patient’s perspective Some patients indicated they would rather live for a little lesser time than prolong their lives with all kinds of troubles due to treatment Discussion Patients who did not accept their physician’s treatment recommendation weighed the benefits of treatment against the probability and severity of side effects Medicine, Ethics, andLaw Competent patient has the right to refuse medical treatment Issue becomes problematic when a patient’s refusal conflicts with medical opinion Patient expresses a nonrational preference, physicians face a dilemma between their duty to care for a patient and respect for patient autonomy Issue become less problematic ‘‘good reasons’’ to refuse a recommended oncological treatment from both the medical and the patient’s perspective based on specific values Physicians find it less difficult to accept a patient’s refusal of a non-curative treatment even if the refusal is, from a medical perspective, based on irrational grounds place more emphasis on the patient’s value system Acceptance of patient’s treatment refusal Acceptance of treatment refusal is important for the physician–patient relationship crucial to his or her attitude towards the patient he or she is often inclined to persist in convincing the patient to accept the treatment patients experiencing that they are not really free to make their decisions, leading to frustration and miscommunication Thank for your attention! Supervisor: 方文貴醫師 Reporter: PGY 江孟舫醫師 醫學倫理定義 人類是非價值的應用，使醫療照顧具有道德性。 包含醫療行為的道德判斷。  是醫療照顧環境中，倫理原則實際的應用。  醫學倫理發展史 1800 B.C. Hammurabi 法典就提到”醫師”的職責。  500 B.C.希伯克拉底誓言(Hippocratic oath):內容除關於疾病的觀察、治療、診斷和醫師們所必須負擔的責任外，也包涵了醫師的一種宣誓。  1200 A.D. R