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

1.基于以下两个基本理念，我们与哲学家和医务人员合作，试图构建一套切实可行的医务人员临床伦理体系。首先，医疗实践必须以一定的价值为前提，从许多可能的价值中选择一个可以表达的价值，一个人的寿命越长，其质量越高越好。其次，医疗实践应该是医务人员、患者和他/她的家人之间的合作。关于医学的伦理原则，通过对著名的四大原则(仁爱、非恶意、尊重自主和平等)的批判和修改，我们得出了以下制度。P1旨在促进患者的福祉R1-1打算使患者的生活质量的综合总和尽可能高。R1-2不阻止患者过上完整的生活。P2将患者视为一个人。R2-1与患者(及其家人)合作行医。R2-2在痛苦中支持患者(及其家人)。P3公正或平等3。我们已经构建了一种格式，作为一份情况说明书，用于审查基于上述伦理原则的共同决策过程。此外，我们还构建了一种格式，用于检查关于患者和医务人员的历史的叙述，其中可能包括一些伦理问题。使用这些格式，医务人员能够适当地分析他们的实践的伦理方面。

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.