社会工作在器官捐献实务中的伦理困境及对策研究

发布时间：2018-06-17 11:59

本文选题：器官捐献 + 医务社工　；参考：《上海师范大学》2017年硕士论文

【摘要】：捐献协调员在器官捐献过程中发挥着举足轻重的作用,随着医疗制度的改革,越来越多的医疗机构开始设立医务社会工作岗位,受过专业训练的医务社会工作者(以下简称“医务社工”),其知识结构和能力更加匹配器官协调员的要求,因此越来越多的医务社工通过培训、考核,进入器官捐献协调员队伍。但由于器官捐献涉及许多伦理问题,而医务社工有其专业的价值观和伦理守则,使得医务社工在开展器官捐献协调过程中,常会陷入各种伦理困境。本研究希望通过医务社工在器官捐献过程中的伦理困境研究,找出其伦理决策的相关因素及观点。本研究目的如下:一、探讨医务社工在器官捐献过程中,对于伦理困境的认知、进行伦理决策的因素。二、帮助医务社工对器官捐献过程中的伦理困境及决策有更清楚的自我认知及专业掌握。三、通过研究,让医务社工了解自省个人生命经验与价值观对器官捐献工作的影响。本研究旨在探讨器官捐献社会工作实务过程中医务社工对相关伦理议题的察觉,以及其决策的过程与因素。医务社工在面对捐献者及家属、医疗团队、法律法规及社会文化等等的交互影响之下,到底哪些伦理议题容易使医务社工产生困境?医务社工又如何在有限的时间内,进行相关决策?基于这个动机,本研究通过访谈资料收集的方法,访谈了在医疗机构中从事器官捐献的医务社会工作者,从而达到对本研究的了解,让研究者对器官捐献社会工作实务工作与本研究议题有了更深的认识和理解。研究发现:(一)在维护捐赠者知情同意权利的情境、捐献者与受赠者隐私的保护、专业角色和团队期待之间的冲突、医务社工个人价值观的冲突等情境中易使医务社工产生伦理困境。(二)医务社工进行伦理决策的主要原则为坚持保密原则、法律规定为根本、以案主及家属利益为原则等。针对上述研究发现,在最后的研究建议部分笔者提出,在个人方面,将伦理决策行动过程列入个案记录的一部分,同时通过不断反思自身对生命的态度,审视个人价值观的影响;在部门层面,通过督导方式提升器官捐献新进医务社工的专业能力;在医院层面,通过团队会议建立共识并信任专业间评估,同时建构良好的机构伦理氛围环境;对社会大众层面,在宣传倡导器官捐献的同时确保对捐献者及家属隐私的尊重。
[Abstract]:The coordinator of donation plays an important role in the process of organ donation. With the reform of medical system, more and more medical institutions begin to set up medical social work posts. The knowledge structure and ability of professionally trained medical social workers (hereinafter referred to as "medical social workers") are more consistent with the requirements of organ coordinators. Therefore, more and more medical social workers are trained and assessed. Enter the organ donation coordinator team. However, organ donation involves many ethical issues, and medical social workers have their professional values and codes of ethics, which makes medical social workers often fall into various ethical difficulties in the process of organ donation coordination. The purpose of this study is to find out the relevant factors and viewpoints of the ethical decision by studying the ethical dilemma of medical social workers in the process of organ donation. The purpose of this study is as follows: 1. To explore the factors of ethical decision-making of medical social workers in organ donation. Second, to help medical social workers to have a clearer understanding of the ethical dilemma and decision-making in organ donation. Third, through the research, let medical social workers understand the influence of personal life experience and values on organ donation. The purpose of this study was to investigate the perceived ethical issues of medical social workers in the social work of organ donation, as well as the decision-making process and factors. Medical social workers in the face of donors and family members, medical teams, laws and regulations, social culture and so on, which ethical issues are likely to cause difficulties for medical social workers? How can medical social workers make relevant decisions in the limited time? Based on this motivation, this study interviewed medical social workers engaged in organ donation in medical institutions through the method of data collection, so as to get a better understanding of this study. So that researchers have a deeper understanding of the social work of organ donation and the subject of this study. The study found that in the context of safeguarding the donor's right to informed consent, the protection of the privacy of the donor and recipient, the conflict between professional roles and team expectations, The conflict of personal values of medical social workers can easily lead to ethical dilemmas for medical social workers. (2) the main principles of ethical decision-making of medical social workers are to adhere to the principle of confidentiality, the legal provisions are fundamental, and the interests of the victims and their families are taken as the principle. In response to the findings of the above study, in the final part of the research recommendations, the author proposes that, in the personal aspect, the process of ethical decision-making action should be included in the record of individual cases, and at the same time, through continuous reflection on their attitude towards life, To examine the impact of individual values; to enhance the professional competence of new medical social workers in organ donation through a supervisory approach at the departmental level; and at the hospital level, to build consensus and trust inter-professional assessments through team meetings, At the same time, it establishes a good environment of institutional ethics, and advocates organ donation while ensuring respect for the privacy of donors and their families.
【学位授予单位】：上海师范大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：C916

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