Bulgaria at the onset of clinical ethics consultation.

IF 1.6 Q2 ETHICS
Silviya Aleksandrova-Yankulovska
{"title":"Bulgaria at the onset of clinical ethics consultation.","authors":"Silviya Aleksandrova-Yankulovska","doi":"10.1007/s40592-022-00158-4","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Over the years, Bulgarian bioethics has been mainly an academic enterprise and fallen short of providing health professionals with skills for ethical decision-making. Clinical ethics support (CES) was piloted by the author through two bottom-up models - METAP (Modular, Ethical, Treatment, Allocation of resources, Process) and MCD (Moral Case Deliberation).</p><p><strong>Aims: </strong>This paper aims to present and analyse developments in the area of clinical ethics and the first experiences in CES in Bulgaria.</p><p><strong>Methodology: </strong>The project reported here included a review of relevant literature on CES methods and evaluation and a documentary review of data from two CES pilot projects: METAP and MCD.</p><p><strong>Results: </strong>Most of the 69 METAP ethics meetings reviewed were first time meetings (88,4%); the average duration was 36 min and the average number of participants was four (44,9%). The meetings were organized in response to cases of severely or critically ill patients. The ethical dilemmas included choice of treatment (31,9%) and conflicts with the patient or their relatives (23,2%). Consensus was achieved in 34,8% of the cases. The situation was clarified with the patient (27,5%) and within the team (15,9%). The rights and obligations of both sides were discussed in 7,2% of the cases. The experience of the members of the Bulgarian Association of Bioethics and Clinical Ethics (BABCE) with MCD was also presented to justify the inference about the applicability of the two CES models in a Bulgarian context.</p><p><strong>Conclusion: </strong>Among Eastern European countries Bulgaria has made progress in CES. Both METAP and MCD have been found to be useful methods.</p>","PeriodicalId":43628,"journal":{"name":"Monash Bioethics Review","volume":"40 Suppl 1","pages":"6-27"},"PeriodicalIF":1.6000,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Monash Bioethics Review","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1007/s40592-022-00158-4","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ETHICS","Score":null,"Total":0}
引用次数: 0

Abstract

Background: Over the years, Bulgarian bioethics has been mainly an academic enterprise and fallen short of providing health professionals with skills for ethical decision-making. Clinical ethics support (CES) was piloted by the author through two bottom-up models - METAP (Modular, Ethical, Treatment, Allocation of resources, Process) and MCD (Moral Case Deliberation).

Aims: This paper aims to present and analyse developments in the area of clinical ethics and the first experiences in CES in Bulgaria.

Methodology: The project reported here included a review of relevant literature on CES methods and evaluation and a documentary review of data from two CES pilot projects: METAP and MCD.

Results: Most of the 69 METAP ethics meetings reviewed were first time meetings (88,4%); the average duration was 36 min and the average number of participants was four (44,9%). The meetings were organized in response to cases of severely or critically ill patients. The ethical dilemmas included choice of treatment (31,9%) and conflicts with the patient or their relatives (23,2%). Consensus was achieved in 34,8% of the cases. The situation was clarified with the patient (27,5%) and within the team (15,9%). The rights and obligations of both sides were discussed in 7,2% of the cases. The experience of the members of the Bulgarian Association of Bioethics and Clinical Ethics (BABCE) with MCD was also presented to justify the inference about the applicability of the two CES models in a Bulgarian context.

Conclusion: Among Eastern European countries Bulgaria has made progress in CES. Both METAP and MCD have been found to be useful methods.

保加利亚开始进行临床伦理咨询。
背景:多年来,保加利亚生物伦理学主要是一项学术事业,未能为卫生专业人员提供伦理决策的技能。临床伦理支持(CES)由作者通过METAP(模块化、伦理、治疗、资源分配、过程)和MCD(道德案例审议)两个自下而上的模型进行试点。目的:本文旨在介绍和分析临床伦理学领域的发展和保加利亚CES的第一次经验。方法:这里报告的项目包括对CES方法和评价的相关文献的审查,以及对两个CES试点项目METAP和MCD的数据的文献审查。结果:69次METAP伦理会议中,绝大多数为首次会议(88.4%);平均持续时间为36分钟,平均参与者人数为4人(44.9%)。这些会议是针对重症或危重病人的病例而组织的。伦理困境包括治疗选择(31.9%)和与患者或其亲属的冲突(23.2%)。34.8%的病例达成共识。患者(27.5%)和团队(15.9%)明确了这一情况。在7.2%的案例中讨论了双方的权利和义务。还介绍了保加利亚生物伦理学和临床伦理学协会(BABCE)成员在MCD方面的经验,以证明两种CES模型在保加利亚情况下适用性的推断是合理的。结论:在东欧国家中,保加利亚在消费电子学方面取得了进步。METAP和MCD都是有用的方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
CiteScore
2.70
自引率
6.20%
发文量
16
期刊介绍: Monash Bioethics Review provides comprehensive coverage of traditional topics and emerging issues in bioethics. The Journal is especially concerned with empirically-informed philosophical bioethical analysis with policy relevance. Monash Bioethics Review also regularly publishes empirical studies providing explicit ethical analysis and/or with significant ethical or policy implications. Produced by the Monash University Centre for Human Bioethics since 1981 (originally as Bioethics News), Monash Bioethics Review is the oldest peer reviewed bioethics journal based in Australia–and one of the oldest bioethics journals in the world. An international forum for empirically-informed philosophical bioethical analysis with policy relevance. Includes empirical studies providing explicit ethical analysis and/or with significant ethical or policy implications. One of the oldest bioethics journals, produced by a world-leading bioethics centre. Publishes papers up to 13,000 words in length. Unique New Feature: All Articles Open for Commentary
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信