以病人安全為服務導向之護理倫理議題

Nursing Ethics Issues for Patient Safety-Oriented Services

21世紀在全球化、科技化、資訊化、高齡化與競爭化的發展趨勢下，對社會人口結構、經濟環境、貧富差距、族群融合、醫護專業特質與價值觀等層面已產生莫大之衝擊，衍生之治療環境、病人安全、醫護病關係、多元文化下之治療模式、生命延續等倫理法律議題日趨複雜，已非昔日醫療情境單純提供醫療服務所能相比，護理人員為醫療團隊之一員，當置身於以病人安全與服務導向的年代，如何同時兼顧維護民眾就醫安全與提高專業照護品質，對醫護工作者產生沉重的負擔，護理人員若長期置身倫理困境中，易衍生工作壓力、影響護理專業功能的發揮與民眾信賴度。因而更突顯培養倫理分析與解決倫理困境等能力之重要性。本文將藉由文獻查證，探討多元時代下治療環境、病人安全、醫院企業化經營下醫療人員的勞動條件等衍生之倫理議題，目的在協助護理人員與醫院行政者省思與解決以上之倫理困境，捍衛病人就醫與醫護人員之安全。

Facing the trends of globalization, technology, informatics, aging and competing society in the 21st century, there are great impacts affecting areas on social demographic structure, economic environment, the wealth gap, ethnic integration, health care professional characteristics and values. Thus, ethnical and legal issues such as medical treatment environment, patient safety, doctor-patient relationship, multicultural treatment model, and the continuation of life are getting more and more complicated. This is incomparable to just providing medical services like traditional way. Being a nurse in a medical team, it is hard to keep balance between maintaining safe medical treatment for the public and upgrading professional quality care in patient safety and service oriented era. If nurses keep in ethical dilemma, the job related stress will easily affect quality of nursing care and public reliability. Therefore, the importance of fostering capabilities on ethical analysis and dealing with ethical dilemma can't be neglected. By literature review, the ethical issues as treatment settings, patient safety, and working conditions of medical staffs managed by hospital enterprises will be discussed. The purpose is to assist nurses and hospital executives to deal with the above ethical dilemma to protect the safety of patient and medical staff in the future.