摘要
急诊患者滞留是全球医院面临的普遍问题,除了医疗问题之外,社会、家庭、经济等问题也会导致患者滞留急诊,不仅给患者自身疾病救治与医院运行管理带来了挑战,也带来了伦理困境。以上海市E医院医务社工介入滞留患者的服务案例为例,对20份服务记录及接案社工的访谈进行分析,梳理医务社工介入急诊滞留患者过程中面临的伦理困境。研究发现,医务社工介入急诊滞留患者的过程中,面临人情与相关法律规定、生命健康权与知情同意权、案主自决与医疗卫生资源分配等方面的伦理困境。对此,建议通过倡导政策制度完善,构建合作团队畅通转介渠道,强化教育、促进家庭共同决策以解决急诊患者滞留问题。
The retention of emergency patients is a common problem faced by hospitals worldwide.In addition to medical problems,social,family,economic and other problems will also cause patients to stay in the emergency department.It not only brings challenges to patientsown disease treatment and hospital operation and management,but also brings ethical dilemmas.Taking the service cases of medical social workers who involved in stranded patients in Shanghai E Hospital as an example,this paper analyzed 20 service records and interviews with social workers receiving cases,and combed the ethical dilemmas faced by medical social workers in the process of involving in emergency stranded patients.It was found that medical social workers faced many ethical dilemmas in the process of involving in emergency stranded patients,such as interpersonal relations and relevant legal regulations,the right to life and health and the right to informed consent,the self-determination of case owners and the allocation of medical resources.In this regard,it is suggested to solve the problem of patient retention by advocating the improvement of relevant systems and policies,building cooperative teams to smooth referral channels,strengthening education,and promoting family shared decision-making.
作者
彭雁楠
庄洁
陈波
沈宜君
吴晓慧
PENG Yannan;ZHUANG Jie;CHEN Bo;SHEN Yijun;WU Xiaohui(Department of Social Work,Shanghai East Hospital,Shanghai 200120,China)
出处
《中国医学伦理学》
2023年第8期873-879,共7页
Chinese Medical Ethics
基金
上海市医院协会医院管理研究基金青年课题“个案管理视角下医务社工介入急诊滞留患者的路径研究”(Q2021022)。
关键词
医务社工
滞留患者
家庭共同决策
伦理困境
Medical Social Workers
Stranded Patients
Family Shared Decision-Making
Ethical Dilemma
