中国医学伦理学2025，Vol.38Issue(6)：781-789,9.DOI:10.12026/j.issn.1001-8565.2025.06.15
医务社会工作中"案主自决"的两难困境与伦理抉择
The dilemmas and ethical choices of"client self-determination"in medical social work
摘要
Abstract
Medical social work requires workers to carry out professional help with values and concepts,and client self-determination is an important principle.However,when intervening in the specific situation of patients with severe illness,social workers often fall into dilemmas of"whether the client continues to receive treatment","whether the client should be informed of their condition",and"whether to intervene when the decision-making causes harm to the client's self-interests."This paper conducted ethical judgments and ethical decision-making analysis regarding pediatric leukemia patients.It also analyzed the pros and cons of client self-determination and limited self-determination from the ethical level of deontology and teleology,as well as appropriate approaches to informed consent.Based on this analysis,suitable action strategies were selected,and final decisions were made.Finally,reflecting on the judgment and choices made throughout the ethical dilemma,it was believed that effective self-determination in professional helping relationships needs to avoid paternalism,be familiar with local culture,develop discretionary rights,as well as engage in individual transcendence and return to virtue theory considerations.关键词
医务社工/案主自决/知情同意/伦理判断/伦理抉择Key words
medical social worker/client self-determination/informed consent/ethical judgment/ethical choice分类
医药卫生引用本文复制引用
钟柳青..医务社会工作中"案主自决"的两难困境与伦理抉择[J].中国医学伦理学,2025,38(6):781-789,9.基金项目
广东省一流本科专业社会工作项目(教高厅函[2022]14号) （教高厅函[2022]14号）
湛江市哲学社会科学规划项目(一般项目)"医务社会工作者伦理困境和应对策略研究"(ZJ23YB28) （一般项目）
广东医科大学博士启动课题"医务社会工作者与案主的多重关系困境和界限管理研究"(4SG24270G) （4SG24270G）
