從醫療弱勢族群的照護看平等權的落實——以同性戀孕產婦為例

The Implementation of the Right to Equality in the Care of a Vulnerable Medical Population: Pregnant and Postpartum Lesbians

醫療平等權是每位就醫者的基本權利，在提倡性別平等國際趨勢中，友善醫療的需求也逐日增加，醫療人員能否秉持公平正義的精神及一視同仁的態度，捍衛就醫者的醫療平等權，特別是弱勢族群，更值得大家重視。本文以同性戀孕產婦的照護為例，深入探討醫療人員的倫理能力，從醫療弱勢族群的就醫者所受的照護品質，反思醫療平等權的落實現況。現今護理養成教育多著重於病人自主權利的維護及倫理決策能力，臨床醫療人員對於維護就醫者醫療平等權的倫理應對能力，常影響個案資料的收集與關係建立，以及使就醫者有被傷害的感受。為有效落實友善醫療，建議可執行下列措施：同理同性戀孕產婦就醫的感受；以不批判個案性傾向並採取一視同仁的態度；重視保密原則、維護其隱私權。醫療人員的倫理能力，有待護理養成教育全面檢視及重視，醫療人員需持續學習及省思，讓友善醫療不落入空談，使每一位就醫者能享有醫療平等權，提升照護品質。

Medical equality is a basic right for patients, and awareness of the need for friendly medical care is increasing alongside international trends of promoting gender equality. Whether clinical professionals are sufficiently enabled and motivated to maintain justice and protect their patients, especially those from vulnerable populations, is an issue that deserves greater attention. We examined the situation of pregnant and postpartum lesbian woman to assess the ethical abilities of clinical professionals. We reflect on whether these patients received appropriate medical care and treatment from the perspective of medical equality. To date, nursing education has placed significantly greater emphasis on protecting the autonomy of patients and on ethical decision-making abilities than on instituting medical equality. In clinical practice, the ethical responses of clinical professionals to equality directly impact vulnerable populations. How clinicians collect clinical data and judge individual cases may cause patients to feel neglected. To carry out friendly medical care effectively, steps must be taken to improve the quality of care. As clinical professionals provide medical treatment, they should be more empathetic toward lesbian postpartum women, maintain an attitude of equality, and refrain from judging the sexual tendencies of individual cases, and protect the privacy of their patients. Regarding the special needs of vulnerable populations, clinical professionals should continue learning and spending time reflecting on methods to improve quality of care.