天主教医疗机构开展临床伦理咨询的指导与方案研究

Mi seon Kim, Eun Ho Park
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摘要

在医疗技术高度发达的多元化社会中,临床伦理咨询在解决医疗伦理冲突中的作用越来越重要。临床伦理咨询是一项支持患者、家属和卫生保健团队在患者护理方面作出知情、审慎决策的活动。韩国从2018年开始实施《临终关怀和缓和疗护法及临终患者维持生命治疗决定》,将临床伦理咨询规定为机构伦理委员会的活动,但韩国大部分医疗机构都不提供临床伦理咨询,即使是占韩国医疗保健8%的天主教医疗机构也是如此。特别是,天主教保健机构应能够提供有效的伦理咨询,包括符合天主教精神的具体伦理准则和活动计划,即使在医疗迅速发展和社会/体制变革的过程中也是如此。因此,天主教主教团联合会议发表的《天主教保健服务伦理与宗教指引:ERDs》作为相应伦理准则的适当范本是恰当的。此外,在启动临床伦理咨询方面取得进展的天主教医疗中心的具体案例可以为其他天主教医疗机构启动临床伦理咨询提供方向,并可作为一个值得所有追求全面保健的医疗机构分享的范例。如果临床伦理咨询在天主教医疗机构中被激活和正确运作,它将成为沟通机构的良心,以实现患者的最大利益,并通过保护医务人员的权利和良心来实现高质量的医疗服务。这将极大地有助于在日益工业化的医疗领域保护天主教保健机构为人的尊严和价值服务的身份。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A Study on Guidelines and Plans for Activating of Clinical Ethics Consultation in Catholic health care Institutions
In the pluralistic society where the medical technology is highly advanced, the role of clinical ethics consultation that helps to solve the ethical conflicts in health care is getting important. Clinical ethics consultation is an activity to support informed, deliberative decision making on the part of patients, families, and the health care team in the patient care. In Korea, clinical ethics consultation was regulated as an activity of the institutional ethics committee with the enforcement of the 「Act on Hospice and Palliative Care and Decisions on Life-sustaining Treatment for Patients at the End of Life」 in 2018, However, most health care institutions in Korea do not provide clinical ethics consultation, and this situation is the same even for Catholic health care institutions, which account for 8 percent of health care in Korea. In particular, Catholic health care institutions should be able to provide effective ethical consultation with specific ethical guidelines and activation plans that are consistent with Catholic spirituality, even in the midst of rapid medical development and social/institutional changes. Therefore, it is judged appropriate to apply the 『Ethics and Religious Directive for catholic Health Care Service : ERDs』 published by United Conference of Catholic Bishops as an appropriate model for the corresponding ethical guidelines. In addition, the specific case of the Catholic Medical Center, which is making progress in activating clinical ethics consultation, can suggest a direction for the activation of clinical ethics consultation in other Catholic healthcare institutions and can be a exemple worth sharing with all medical institutions pursuing holistic health care. If clinical ethics advice is activated and properly operated in Catholic health care institutions, it will become the conscience of the institution communicating to realize the best interests of patients, and high quality health care services will be achieved by protecting the rights and conscience of medical staff. This will be of great help in protecting the identity of a Catholic health care institution serving human dignity and value in the increasingly industrialized medical field.
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