不妊治療を受ける患者の倫理問題分析 : Vulnerability理論とnarrative[患者の語り]の位置づけ

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I evaluated the possibility of bioethical analysis of perception and behavior of patients who are treated for sterility. My study analyzes private papers written by women who underwent sterilization. First, a comparison is made with the model of E. Suchman who pointed out "illness behavior" and "stages of illness". In the present study, frequency of words in women who underwent sterilization treatment were analyzed by using WORD-SEP (frequency of word program). This is the Zipf's law. Zipf interpreted this fact as the one to express the fundamental basis of human behavior for "least effort". This program analyzed the structure of the word frequencies in computer programming languages and manuals of computer by the same method as Zipf. I would turn from the argument of fining the other human activites regarding the various human behaviors whether they show a similar pattern as was found by Zipf or do they show a different pattern. I could approach the study of the structure of human needs of women who underwent sterilization. I have extracted 4 constitutional factors: "watashi", "onna", "jibun", "ko", by analyzing the contents of personal accounts by women who had received treatment for sterility. We hypothesized that these 4 constitutional factors correspond to sterile women's "view of life", "view of children", "view of family", and "view of the society". For evaluation of the validity of this working hypothesis, a bioethical framework was considered necessary. If a couple at reproductive ages wishes to have children but cannot, therapeutic actions are a hope to the couple. However, if patients must live a childless life despite treatment for sterility, they are considered to be in a state of vulnerability. The theory of vulnerability was introduced in Helping and Healing by Edmund D. Pellegrino and David C. Thomasma and is attracting attention in clinical medicine, particularly in the field of nursing ethics, as ethics of the future in theorizing and practicing virtue ethics. To reduce the state of vulnerability, relationships (objective of the couple, relationships with people at the workplace, professional ethics, relationships with the family, relationships with friends, and relationships with benefactors) must be observed carefully in the patient's narratives. Investigation of narrative ethics based on health profession and professional ethics scenes of medical care from the stance of investigators actually involved in medical care in needed.
九州大学の論文

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丸山マサ美
九大医保健学科看護学専攻

不妊治療を受ける患者の倫理問題分析 : Vulnerability理論とnarrative[患者の語り]の位置づけ

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