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基于“四主题理论”的慢性肾衰竭诊疗伦理问题分析——以慢性肾衰竭患者拒绝血液透析为例

白琼,  唐雯,  王悦

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文章导航 > 协和医学杂志  > 2021 >  12(6): 1034-1038
白琼, 唐雯, 王悦. 基于“四主题理论”的慢性肾衰竭诊疗伦理问题分析——以慢性肾衰竭患者拒绝血液透析为例[J]. 协和医学杂志, 2021, 12(6): 1034-1038. doi: 10.12290/xhyxzz.20200169
引用本文: 白琼, 唐雯, 王悦. 基于“四主题理论”的慢性肾衰竭诊疗伦理问题分析——以慢性肾衰竭患者拒绝血液透析为例[J]. 协和医学杂志, 2021, 12(6): 1034-1038. doi: 10.12290/xhyxzz.20200169
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BAI Qiong, TANG Wen, WANG Yue. Analyze Clinical Ethical Issues in the Treatments of Chronic Renal Failure Based on Four Topics Theory: An Example of a Patient with Chronic Renal Failure Refusing Hemodialysis[J]. Medical Journal of Peking Union Medical College Hospital, 2021, 12(6): 1034-1038. doi: 10.12290/xhyxzz.20200169
Citation: BAI Qiong, TANG Wen, WANG Yue. Analyze Clinical Ethical Issues in the Treatments of Chronic Renal Failure Based on Four Topics Theory: An Example of a Patient with Chronic Renal Failure Refusing Hemodialysis[J]. Medical Journal of Peking Union Medical College Hospital, 2021, 12(6): 1034-1038. doi: 10.12290/xhyxzz.20200169
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基于“四主题理论”的慢性肾衰竭诊疗伦理问题分析——以慢性肾衰竭患者拒绝血液透析为例

doi: 10.12290/xhyxzz.20200169

  • 北京大学第三医院肾内科，北京 100191

详细信息
    通讯作者:

    王悦  电话：010-82265026，E-mail：bjwangyue@163.com

  • 中图分类号: R4; G642

Analyze Clinical Ethical Issues in the Treatments of Chronic Renal Failure Based on Four Topics Theory: An Example of a Patient with Chronic Renal Failure Refusing Hemodialysis

  • Department of Nephrology, Peking University Third Hospital, Beijing 100191, China

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    摘要
  • 摘要: 对于慢性肾衰竭患者的治疗，肾内科医生需摆脱“千篇一律”的透析方案，考虑患者生命质量、特定情境因素，尊重患者偏好，并意识到患者参与在确定治疗目标和治疗决策中的重要性。本文以“慢性肾衰竭患者拒绝血液透析”为例，基于临床伦理学“四主题理论”模式，结合医学伦理学原则，剖析慢性肾衰竭患者肾脏替代治疗中面临的临床伦理学问题。医生在提供诊疗建议时既应结合患者偏好，又需保持最佳诊疗质量，最终实现以患者为中心、医患共同决策的诊疗模式。
    Abstract: For the treatment of chronic renal failure, nephrologists should avoid the "one-size-fits-all" dialysis program, consider the patients' quality of life, contextual features, respect patients' preference, and recognize the importance of patients' participation in determining the goal and clinical decision. Based on the "Four Topics Theory" of clinical ethics and the medical ethical principles through an example of a patient that refused hemodialysis for chronic renal failure, this article explores the ethical issues related to the choice of treatment for patients with chronic renal failure. The clinical decision should combine the patient's preference and the best quality of medical care, which ultimately achieves a medical model of patient-centered and shared decisionmaking.
    作者贡献：白琼负责论文撰写及修订；唐雯负责资料收集和论文修订；王悦负责论文审阅。
    利益冲突：无
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    • 参考文献(26)
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出版历程
  • 收稿日期:  2020-06-23
  • 录用日期:  2020-08-17
  • 刊出日期:  2021-11-30

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