クリニカル・エシックスと医療におけるディレンマの意味

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When a physician cannot determine solely medically which course of action he or she should take, his or her decision-making in patient care often requires value judgments on an individual basis. Such a decision with value judgments is usually regarded as ethical decision-making. Ethical decision-making tries to resolve ethical dilemmas that raise when a clinical problem in patient care has plural countervailing resolutions. A physician has to make a choice among several unsatisfactory alternatives in clinical practice. In situation where conflicting two or more actions seem equally legitimate, it is not always possible to resolve ethical dilemmas themselves, rather, his or her decision has to be made even amidst unsolved ethical dilemmas. Furthermore, as far as clinical judgment regarding what is ethically right or wrong depends on value judgment, ethical decision-making made by an individual physician would be unavoidably biased by his or her idiosyncratic value. Under these circumstances, clinical ethics can offer a physician standard guidelines and fair procedures to deal with ethical dilemmas confronted in patient care. Ethical guidelines including decision-making priority used in clinical ethics provide physician's ethical decision-making with consistency and fairness. A framework of ethics consultation is useful to identify, analyze, and cope with ethical dilemmas in systematic manner. Even if an approach in clinical ethics failed to resolve ethical dilemma themselves, its procedure could result in a fair decision acceptable to a patient, physician, and all other parties. Ethical dilemmas in modern medicine may not be resolved, but clinical ethics would help a physician deliberate ethical problems and negotiate a mutually acceptable decision amidst disagreement.
日本生命倫理学会の論文
1996-06-30

クリニカル・エシックスと医療におけるディレンマの意味

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