Construction of a System of Clinical Ethics including Practicable Tools for Case-Examination in Medical Practice

构建临床伦理体系，包括医疗实践中病例审查的实用工具

• 批准号: 11551001
• 负责人: SHIMIZU Tetsuro
• 金额: $ 3.71万
• 依托单位: Tohoku University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (B)
• 财政年份: 1999
• 资助国家: 日本
• 起止时间: 1999 至 2001
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-11551001/
• 关键词: clinical ethics; quality of life; informed consent; withdrawing treatments; process of decision making; narrative; ethical principles; collaboration between medics and the patient; 価値選択; 臨床論理; 緩和医療; 告知; 医療哲学; 自己決定

1. We, philosophers and medics in collaboration, have tried to construct a practicable system of clinical ethics for medics, on the basis of the following two basic ideas. First, medical practice must be premised on a certain value chosen among many possible values, which can be expressed, the longer a life is, and the higher is its quality, the better. Secondly, the medical practice should be a collaboration between medics, the patient, and his/her family.2. As to the ethical principles in medicine, by criticizing and revising the famous four (beneficence, non-maleficence, respect for autonomy, and equality), we have reached the following system.P1 Intend to promote the patient's well-beingR1-1 Intend to make the integrated sum of the patient's QOL as high as possible.R1-2 Don't prevent the patient from leading a full life.P2 Treat the patient as a human being.R2-1 Do medical practice in collaboration with the patient (and his/her family).R2-2 Stand by the patient (and his/her family) in suffering.P3 Justice or equality3. We have constructed a format as a fact sheet for examining a process of shared decision making on the basis of the ethical principles shown above. Also we have constructed a format for examining a narrative that is about the history of a patient and medics that might include some ethical problems. Using these formats, medics become able to analyze appropriately the ethical aspect of their practice.

1.我们，哲学家和医学家共同努力，试图在以下两个基本理念的基础上，构建一个切实可行的医学临床伦理学体系。首先，医疗实践必须建立在从许多可能的价值中选择的某种价值之上，这种价值可以表达为，生命越长，质量越高，越好。第二，医疗实践应该是医生、病人和他/她的家人之间的合作。在医学伦理原则方面，通过对著名的四条原则的批判和修正，（善行、不作恶、尊重自主和平等），我们已经达到了以下系统。P1意图促进患者的福祉R1 -1意图使患者的生活质量的综合总和尽可能高。R1- 2不要妨碍病人过上充实的生活。P2把病人当作人来对待。R2 -1与病人合作进行医疗实践（及其家人）。R2 -2在病人（及其家人）遭受痛苦时站在病人（及其家人）一边。我们已经构建了一个格式，作为一个事实表，用于检查基于上述道德原则的共同决策过程。此外，我们还构建了一个格式，用于检查一个关于病人和医生的历史，可能包括一些伦理问题的叙述。使用这些格式，医务人员能够适当地分析他们的实践的道德方面。

项目成果

清水 哲郎: "QOLの基礎理論・再考"緩和医療学. 2-2. 3-8 (2000)

Tetsuro Shimizu：“QOL 的基本理论和重新思考”姑息医学 2-2（2000）。

清水 哲郎: "人工呼吸器装着・不装着についての事前指示の倫理"厚生省特定疾患対策研究事業 横断的基礎研究 特定疾患患者の生活の質(QOL)の向上に関する研究班 平成11年度報告書. 87-91 (2000)

清水哲朗：“关于使用和不使用呼吸机的预先指示的伦理”厚生省特定疾病对策研究项目、横断面基础研究、改善患者生活质量（QOL）研究小组与特定疾病，1999 年报告 87 -91 (2000)。

SHIMIZU Tetsuro: "From the Rational Autonomous People to the People Sharing their Life (in Japanese)"Studies in Medieval Thought. 42. 161-169 (2000)

清水哲郎：《从理性自治的人到分享生活的人（日语）》中世纪思想研究。

清水哲郎: "QOL研究の意義-哲学的視点から"血液・腫瘍科. 41(6). 518-522 (2000)

Tetsuro Shimizu：“生活质量研究的意义 - 从哲学角度”，血液学和肿瘤学系 41(6) (2000)。

清水 哲郎: "医療現場に臨む哲学II ことばに与る私たち"勁草書房. 195+6+viii (2000)

清水哲朗：“医学领域的哲学 II：我们参与语言”Keiso Shobo 195+6+viii (2000)。