Abstract：
This paper is an exploration of the state of \'clinical unease\' experienced by clinicians in contexts where professional judgement-grounded in clinical knowledge, critical reflection and a sound grasp of the law-indicates that there is more than one ethically defensible way to proceed. The question posed is whether the courts can be viewed as an appropriate vehicle to settle clinical unease by providing a ruling that clarifies the legal and ethical issues arising in the case, even in situations where there is no dispute between the patient (or her proxies) and the healthcare team.The concept of \'clinical unease\' is framed with reference to the broader experience of clinical decision-making, and distinguished from other widely discussed phenomena in the healthcare literature like moral distress and conscientious objection. A number of reported cases are briefly examined where the courts were invited to rule in circumstances of apparent \'unease\'. The respective responsibilities of clinicians and courts are discussed: in particular, their capability and readiness to respond to matters of ethical concern.Four imagined clinical scenarios are outlined where a clinical team might welcome a court adjudication, under current rules. Consideration is given to the likelihood of such cases being heard, and to whether there may be better remedies than the courts. There are final reflections on what clinicians may actually wish for in seeking court involvement, and on whether a willingness to engage with the experience of clinical unease may lead to greater sensitivity towards the value perspectives of others.
摘要：
本文是对临床医生在专业判断以临床知识为基础的背景下经历的“临床不安”状态的探索，批判性的反思和对法律的正确把握-表明有不止一种道德上可以辩护的方式来进行。提出的问题是，是否可以通过提供一项裁决来澄清案件中出现的法律和道德问题，将法院视为解决临床不安的适当工具，即使在患者（或她的代理人）和医疗团队之间没有争议的情况下。“临床不安”的概念是参考更广泛的临床决策经验而制定的，并区别于医疗保健文献中其他广泛讨论的现象，如道德困扰和出于良心拒服兵役。简要审查了一些报告的案件，其中邀请法院在明显的“不安”情况下作出裁决。讨论了临床医生和法院各自的职责：特别是，他们对道德问题做出回应的能力和准备。概述了四种想象中的临床情景，其中临床团队可能欢迎法院裁决，根据现行规则。考虑到审理这类案件的可能性,以及是否有比法院更好的补救措施。关于临床医生在寻求法院介入时可能实际希望的最终思考，以及是否愿意参与临床不安的经历可能会导致对他人价值观点的更大敏感性。
