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1、w页码，1/17(W)9–EthicalAspectsofAnesthesiaCareGailA.VanNorman,StanleyH.RosenbaumKeyPoints1.Anesthesiologistshaveethicalobligationstopromotepatients’abilitiestomakemedicaldecisions,aswellasobligationstorespectthosedecisions.2.Competentpatientshavetherighttorefusemedicaltreatmentsortests,evenifit
2、appearstobea“bad”decision.Coercingorrestrainingcompetentpatientsisunethical.3.Childrenshouldbeinvolvedinmedicaldecision-makingtothedegreethattheirabilitiesallow,andtheirwishesshouldusuallyberespected.4.Advancedirectivesanddecisionsbysurrogatedecision-makersarelegallybinding.5.Do-not-attempt-
3、resuscitationordersrequirereconsiderationbeforeanesthesiaandsurgeryandcannotbeautomaticallysuspended.6.Withdrawalorwithholdingoflife-sustainingtreatmentsattheendofliferequiresspecializedtrainingorexperience.7.Anesthesiologistsplayapivotalroleincaringforbothbrain-deadandnon–heart-beatingorgan
4、donorsandmustbefamiliarwiththemedical,legal,andethicalissuesinvolved.8.Humanandanimalresearchcarriesspecialobligationstoprotectthesubjectsfrominhumanetreatment.Wheneverpossible,alternativestohumanandanimalresearchshouldbesought.9.“State-sponsored”activitiessuchasexecutions(1)arenotthepractic
5、eofmedicine,(2)underminethemedicalprofession,and(3)placethephysicianondubiousmoralgrounds.10.Althoughphysicianshavearighttowithdrawfromsomesituationsinwhichpatientcarepresentsthemwithpersonalmoralconflicts,thisrightislimited,andprofessionallyacceptedstandardsandobligationsusuallyprevail(e.g.
6、,well-establishedstandards,suchasinformedconsent).HistoryofEthicsinMedicineandEthicalTheoryMedicineisarespectedprofessionwithcodesofbehavioranddefiniterulesofconduct.Inmoderntimes,medicalpractitionershavetremendouspowers,recognizedsocialimport,andpowerfulfinancialinteractionsthattouchnearlye
7、veryone'slives.Itisinthecontextoflong-heldandhighlydevelopedrulesandpracticesthatweexaminetheethicalbasesofthepracticeofmedicineanditsimplicationsforanesthesiologists.EthicalTheoryVirtueEthics,Utilitarianism,andDuty-DrivenEthicsTheclassicstyleofmed
