ethical issues in practice

  • 文章类型: Journal Article
    关于跨性别社区的健康和护理需求的讨论比以往任何时候都多。然而,在重症监护病房中,关于跨性别患者护理的研究有限,这可能会导致知识差距,围绕医疗保健实践的不一致和不确定性。本文并非旨在解决ICU中变性人患者的所有特定需求,而是探索在ICU中照顾变性女性的道德考虑。在这样做的时候,本文将探讨一些围绕性别确认护理的具体考虑因素,挑战歧视,生理变化,和系统改变以加强护理。
    There is more discussion than ever surrounding the health and care needs of Transgender communities. However, there is limited research on the care of Transgender patients in the Intensive Care Unit which can contribute to knowledge gaps, inconsistencies and uncertainties surrounding health care practices. This article is not intended to address all of the specific needs of Transgender patients in ICU, but to explore the ethical considerations for caring for a Transgender woman in the ICU. In doing so, this article will explore some specific considerations around gender affirming care, challenging discrimination, physiological changes, and systems change to enhance care.
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  • 文章类型: Journal Article
    背景:道德冲突嵌入医疗保健中,在重症监护环境中很常见。然而,关于中国伦理冲突本质的研究很少。伦理冲突具有文化和语境敏感性。因此,需要来自不同背景的证据来帮助跨境讨论这个问题。
    目的:本研究旨在定性地识别中国重症监护专业人员的伦理冲突经历。
    方法:从2021年12月到2022年2月,我们进行了半结构化,对来自中国某三级综合医院5个重症监护病房的21名重症监护专业人员进行面对面访谈。采用专题分析方法对数据进行分析。
    结果:数据中出现了5个主题和14个子主题。重症监护专业人员可能觉得无法驾驭不确定性,被家庭问题撕裂了,对医务人员的不专业行为感到愤怒,在经历道德冲突时陷入社会经济困境。此外,他们还意识到他们可以把奋斗变成成长。
    结论:重症监护专业人员的道德冲突经历涉及多种感受。这项研究全面了解了道德冲突如何影响他们对自己和职业的看法,并为制定有效的应对策略提供了启示。
    结论:确定重症监护专业人员的道德冲突经验将有助于确定什么可能引发道德问题,以及什么是关键实践中需要优化的潜在目标。
    Ethical conflict is embedded in healthcare and is common in critical care setting. However, there is a paucity of research on the nature of ethical conflict in China. Ethical conflict has cultural and context sensitivity. Therefore, evidence is needed from different backgrounds to help discuss this issue across borders.
    This study aimed to qualitatively identify the experience of ethical conflict in critical care professionals in China.
    From December 2021 to February 2022, we performed semi-structured, face-to-face interviews with 21 critical care professionals from five intensive care units in a tertiary general hospital in China. A thematic analysis approach was used to analyse the data.
    Five themes and 14 sub-themes emerged from the data. Critical care professionals probably felt unable to navigate uncertainty, torn by family issues, outraged by unprofessional behaviours of medical staff, being trapped in a socioeconomic dilemma when having experience of ethical conflict. In addition, they also perceived that they could turn struggle into growth.
    The experience of ethical conflict in critical care professionals involved a mixture of feelings. This study builds a comprehensive understanding of how ethical conflict affected their perceptions of themselves and their profession and provides implications to develop effective coping strategies.
    The identification of critical care professionals\' experience of ethical conflict would help identify what might trigger the ethical issues and what would be the potential target to optimize in critical practice.
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