生体肝移植に関わるクリニカル移植コーディネーターの倫理的概念  [in Japanese] Ethical concept of clinical transplant coordinators in living donor liver transplantation  [in Japanese]

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Author(s)

    • 習田 明裕 Shuda Akihiro
    • 東京医科歯科大学大学院保健衛生学研究科健康情報分析学:首都大学東京人間健康科学研究科看護科学域 Analytical Health Science, Graduated School of Health Care Sciences, Tokyo Medical and Dental University:Department of Nursing Sciences, Graduate School of Human Health Sciences, Tokyo Metropolitan University

Abstract

本研究は,生体肝移植に関わるクリニカル移植コーディネーター(以下CTC)が抱えている倫理的問題を明らかにし,その状況下で抱いたCTCの「思い」から,倫理的概念を抽出し,記述することを目的とした。7施設11名のCTCに対して面接調査を行った結果,84のエピソードから【ドナーの自律性が担保されない】【尊厳が保てない】【善行と無害の均衡が取れない】【責務の揺らぎ】【責務が遂行できない】【自分には相容れない】の6つのカテゴリーに分類される倫理的問題が明らかにされた。さらに,その状況下でCTCが抱いた138の「思い」を分析した結果,【意思を尊重する】【ありのままの事実を伝える】【ドナーの価値観に根ざした決定を支える】【人として尊重する】【対象者に対する責務を果たす】【他職種と協力しながら専門性を発揮する】【公平・平等に進めていくプロセスを重視する】【ドナーの傍らで共感し思いを汲み取る】の8つの倫理的概念が抽出された。

The purposes of this study were (1) to elucidate ethical problems that clinical transplant coordinators (CTCs) face routinely and (2) to explore and delineate ethical concepts for nursing practice developed from their "ideals" in such situations. An interview was conducted in 11 CTCs from 7 institutions. Ethical problems were elucidated which were classified into six categories based on 84 episodes: "no guarantee of donor's autonomy," "no preservation of dignity," "inability to balance beneficence and nonmaleficence," "variability of responsibilities," "inability to fulfill their responsibilities," and "incompatibility with own values." Further analysis was performed for 138 "ideals" of CTCs in such situations. As a result, eight ethical concepts were revealed: "respect for the intention," "communication of facts as they are," "support of decisions based on the values of the donor," "respect as a human being," "fulfillment of responsibilities toward the subjects," "demonstration of professional expertise by cooperating with professionals in other fields," "emphasis on the process for impartial and fair progression," and "sympathy and understanding toward the subject."

Journal

  • The Journal of Japan Academy of Health Sciences

    The Journal of Japan Academy of Health Sciences 13(4), 177-192, 2011

    Japan Academy of Health Sciences

References:  32

Codes

  • NII Article ID (NAID)
    110008593402
  • NII NACSIS-CAT ID (NCID)
    AA12001334
  • Text Lang
    JPN
  • Article Type
    Journal Article
  • ISSN
    1880-0211
  • NDL Article ID
    11068668
  • NDL Source Classification
    ZS7(科学技術--医学)
  • NDL Call No.
    Z74-B494
  • Data Source
    CJP  CJPref  NDL  NII-ELS  J-STAGE 
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