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Utilitarian Principlism as a Framework for Crisis Healthcare Ethics
HEC Forum ( IF 1.3 ) Pub Date : 2021-01-15 , DOI: 10.1007/s10730-020-09431-7
Laura Vearrier 1 , Carrie M Henderson 2
Affiliation  

This paper introduces the model of Utilitarian Principlism as a framework for crisis healthcare ethics. In modern Western medicine, during non-crisis times, principlism provides the four guiding principles in biomedical ethics—autonomy, nonmaleficence, beneficence, and justice; autonomy typically emerges as the decisive principle. The physician–patient relationship is a deontological construct in which the physician’s primary duty is to the individual patient and the individual patient is paramount. For this reason, we term the non-crisis ethical framework that guides modern medicine Deontological Principlism. During times of crisis, resources become scarce, standards of care become dynamic, and public health ethics move to the forefront. Healthcare providers are forced to work in non-ideal conditions, and interactions with individual patients must be considered in the context of the crisis. The COVID-19 pandemic has forced healthcare to shift to a more utilitarian framework with a greater focus on promoting the health of communities and populations. This paper puts forth the notion of Utilitarian Principlism as a framework for crisis healthcare ethics. We discuss each of the four principles from a utilitarian perspective and use clinical vignettes, based on real cases from the COVID-19 pandemic, for illustrative purposes. We explore how Deontological Principlism and Utilitarian Principlism are two ends of a spectrum, and the implications to healthcare as we emerge from the pandemic.

中文翻译:

功利主义原则作为危机医疗伦理的框架

本文介绍了作为危机医疗伦理框架的功利主义模型。在现代西方医学中,在非危机时期,原则主义提供了生物医学伦理学的四大指导原则——自主、无恶意、仁慈和正义;自治通常作为决定性原则出现。医患关系是一种义务论结构,其中医生的主要职责是对个体患者负责,而个体患者是至高无上的。出于这个原因,我们称之为指导现代医学道义原则的非危机伦理框架。在危机时期,资源变得稀缺,护理标准变得充满活力,公共卫生伦理成为首要问题。医疗保健提供者被迫在非理想条件下工作,必须在危机的背景下考虑与个别患者的互动。COVID-19 大流行迫使医疗保健转向更实用的框架,更加注重促进社区和人群的健康。本文提出了功利主义的概念作为危机医疗伦理的框架。我们从功利主义的角度讨论这四项原则中的每一项,并根据 COVID-19 大流行的真实案例使用临床小插曲来进行说明。我们探讨道义原则和功利主义原则如何成为光谱的两端,以及我们从大流行中出现时对医疗保健的影响。COVID-19 大流行迫使医疗保健转向更实用的框架,更加注重促进社区和人群的健康。本文提出了功利主义的概念作为危机医疗伦理的框架。我们从功利主义的角度讨论这四项原则中的每一项,并根据 COVID-19 大流行的真实案例使用临床小插曲来进行说明。我们探讨道义原则和功利主义原则如何成为光谱的两端,以及我们从大流行中出现时对医疗保健的影响。COVID-19 大流行迫使医疗保健转向更实用的框架,更加注重促进社区和人群的健康。本文提出了功利主义的概念作为危机医疗伦理的框架。我们从功利主义的角度讨论这四项原则中的每一项,并根据 COVID-19 大流行的真实案例使用临床小插曲来进行说明。我们探讨道义原则和功利主义原则如何成为光谱的两端,以及我们从大流行中出现时对医疗保健的影响。出于说明目的,基于 COVID-19 大流行的真实案例。我们探讨道义原则和功利主义原则如何成为光谱的两端,以及我们从大流行中出现时对医疗保健的影响。出于说明目的,基于 COVID-19 大流行的真实案例。我们探讨道义原则和功利主义原则如何成为光谱的两端,以及我们从大流行中出现时对医疗保健的影响。
更新日期:2021-01-15
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