The ethics of blood transfusion refusal in clinical practice among legal and medical professions in Japan
The ethics of blood transfusion refusal in clinical practice among legal and medical professions in Japan
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DOI：
10.18999/nagjms.82.2.193
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发表时间：
2020-05-01
影响因子：
0.9
通讯作者：
Iijima, Yoshihiko
中科院分区：
文献类型：
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作者：
Iijima, Yoshihiko
我们以以宗教原则为理由拒绝输血为临床伦理问题的一个例子，调查了日本和美国医学和法律专业人士对临床伦理问题的伦理支持的不同意见。在日本医疗机构伦理支持体系中，95.0%的“临床培训指定医院”设有医院伦理委员会，63.1%设有医疗安全部门；临床伦理支持是根据其规模和功能来提供的。对于临床伦理支持是否限制医生的自由裁量权，有59.2%的律师回答“否”，54.4%的医生回答“是”。此外，对于政府或学术指南在临床实践中的可行性，37.7%的律师回答“是”，63.0%的医生回答“否”。对于“相对无输血”政策，83.2%的律师和76.8%的医生回答“不可避免”，而81.6%的美国委员会主任回答“侵犯权利”。在因医院无法治疗拒绝输血的患者而导致的医院转移方面，62.6%的律师认为这是“不可避免的”，而57.1%的美国委员会负责人认为这是“应该避免的”。这项研究的结果表明，医学和法律专业人士和美国伦理委员会负责人对临床伦理问题的认识略有不同。
We investigated the differences in Japanese and United States medical and legal professional opinions on ethical support for clinical ethical issues using the refusal of blood transfusions on the grounds of religious principles as an example of a clinical ethical issue. In ethical support systems for medical institutions in Japan, 95.0% of "clinical training designation hospitals" have hospital ethics committees, and 63.1% have medical safety divisions; clinical ethical support is provided in accordance with their scale and function. In terms of clinical ethical support limits the discretion of physicians, 59.2% of lawyers responded "No" and 54.4% of doctors responded "Yes". In addition, on the feasibility of government or academic guidelines in clinical practice, 37.7% of lawyers responded "Yes" and 63.0% of doctors responded "No". In terms of "relative transfusion-free" policy, 83.2% of lawyers and 76.8% of doctors responded that it is "unavoidable," while 81.6% of U.S. committee heads responded that it is a "violation of rights." In terms of hospital transfers due to a hospital being unable to treat patients refusing blood transfusion, 62.6% of lawyers reported that it is "unavoidable" while 57.1% of U.S. committee heads reported that it "should be avoided". The results of this study indicate that medical and legal professionals and U.S. ethics committee heads recognize clinical ethical issues in slightly different ways.