Getting rights right: implementing 'Martha's Rule'.
Getting rights right: implementing 'Martha's Rule'.
复制标题
获得正确的权利：实施“玛莎规则”。
DOI：
10.1136/jme-2023-109650
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发表时间：
2024
影响因子：
4.1
通讯作者：
Graham M
中科院分区：
文献类型：
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作者：
Graham M
英国政府最近承诺采取一项名为“玛莎规则”的新政策，其特点是为患者提供在紧急或有争议的病例中快速获得第二临床意见的权利。2021年，玛莎·米尔斯去世后，尽管她的父母提出了担忧，但医生没有让她进入重症监护室，对这一规则的支持也随之出现。我们认为，在病人的权利方面制定这个问题是没有成效的，应该避免。尽管玛莎规则的最终目标是提供保护患者安全的临床服务，但关注卫生系统义务而不是患者个人权利的方法将更好地服务于这一目标。我们概述了一种替代方法，定位快速临床审查的一套服务的一部分，旨在加强和保护病人的护理。这种方法将在解决玛莎规则没有解决的系统性难题方面取得更大进展，同时也能更好地应对临床实践的限制。
The UK government has recently committed to adopting a new policy—dubbed ‘Martha’s Rule’—which has been characterised as providing patients the right to rapidly access a second clinical opinion in urgent or contested cases. Support for the rule emerged following the death of Martha Mills in 2021, after doctors failed to admit her to intensive care despite concerns raised by her parents. We argue that framing this issue in terms of patient rights is not productive, and should be avoided. Insofar as the ultimate goal of Martha’s Rule is the provision of a clinical service that protects patient safety, an approach that focuses on the obligations of the health system—rather than the individual rights of patients—will better serve this goal. We outline an alternative approach that situates rapid clinical review as part of a suite of services aimed at enhancing and protecting patient care. This approach would make greater progress towards addressing the difficult systemic issues that Martha’s Rule does not, while also better engaging with the constraints of clinical practice.