急診醫療服務之醫學倫理

Medical Ethics of the Services in Emergency Departments

李建賢(Chen-Hsen Lee)

《Journal of Medical Education》 8卷3期 (2004/09) Pp. 327-335

https://doi.org/10.6145/jme.200409_8(3).0010

摘要

在台灣，急診醫療服務隨著國家經濟快速發展而現代化，但急診服務之倫理期念卻未因爲醫療水准的改善而有同質性提昇。在民衆普遍認定大醫院是急重症患治病患冶病的護身符之際，各醫學中心急診部門卻爲此類突發性急重症病患擁擠不堪而産生功能上的危機。在急診醫療業服中，包括心髒停止病患的急救與否，快速診斷能力及治療的電動機、效果與採用新技術新藥的適應症，病患家屬迫切了解病情之需求性，嚴重病患住院或轉院之轉治流程，病患隱私權與利益之保障等醫學倫理上的問題，正每天在台灣各醫院急診室內重複地發生，因而免不了産生醫護與病患間、醫院與醫院間、醫師與醫師間這倫理紛爭，且時時刻刻衝擊著台灣的醫療體系。在相關性法律尚未健全之下，加強醫療倫理的概念是保障與提昇急診醫療服務品質之不二法門，針對以上有關急診醫療服務之醫療倫理教育需求面，本人根據過去17年來服務於急診部門的經驗，並參攷國外相關文獻提出個人見解，希籍些抛磚引玉起醫界先進與同仁們，廣泛性對急診醫療倫理之重視，在第一霎時間內攜手同心全力地診治每一位至急診求診的病患。

關鍵字

醫療倫理 ； 醫療服務 ； 急診部門（急診室）

並列摘要

The quality of medical services at emergency departments (ED) has improved over the past few years, in particular due to the rapid economic development and technical modernization of Taiwan. However, the medical ethics in ED practice has not paralleled this improvement in medical services. The prevailing concept that larger hospitals have better quality assurance in the management of acute or critically ill patients has led to them becoming overcrowded and this has resulted in malfunctioning of the management systems in EDs, especially in medical centers. The medical services in EDs include resuscitations, prompt diagnosis and timely treatments, the inter- or intra-hospital transfer of critically ill patients, the warranty of patients' privacy and benefits, and at the same time, the understanding and handling of patient's family needs. Therefore, the endless ethical problems of the medical services in EDs, which involve patient-doctor, patient-nurse, families-caregiver, hospital-hospital and doctor-doctor interactions, can have a continuous major impact on emergency care in this country. The best way to ensure and upgrade the quality of medical services in EDs must be to emphasize enhancement of medical ethics education, regardless of the lack of medicine-related law. Based on my 17-years experiences as a chairman in a medical center ED and related studies from Western countries, I proposed through this article to highlight the needs and improvements required of ethical education for medical services in EDs. Hopefully, this will raise the consciousness of colleagues to the requirements of medical ethics, so that they can serve well every patient receiving attention at an ED from the ve1y beginning. (Full text in Chinese)

並列關鍵字

medical ethics ； medical services ； emergency department

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