Identification of Bioethical Dilemmas, Ethical Reasoning, and Decision- Making in Military Emergency Medicine Departments.

摘要

Recent advances in medical technology and research have made possible an unprecedented level of health care for those living in economically advanced nations like the United States. Fast-acting pharmaceuticals, cardiac defibrillators, assisted-ventilation, telemedicine, artificial organs, and transplantation are just a few of the weapons in our medical arsenal today that simply did not exist only fifty years ago. Nowhere is this more evident than in the pre-hospital or emergency medicine arena, where providers are faced with advanced medical technology that has often made dying a choice rather than an inevitable event. Not coincidentally, the field of bioethics has also experienced unprecedented growth over the same time span, with many of the bioethical issues being driven by the power of our new technological medical prowess. All too often it seems as though medicine asks 'Can we.' before asking 'Should we.' and therefore many Americans are doubtful that bioethics can ever keep pace with rapidly changing technologies. As technologies advance and the healthcare environment changes, the struggle to identify pertinent bioethical issues has prompted numerous institutional efforts, including initiatives of the American Association of Bioethics, The Center for Bioethics, and the Hastings Center for Bioethics, whose goal is to expand bioethical education and stimulate discussion of bioethical issues.