Ethics;
Ethics-;
Medical;
Medical Errors;
Public Policy;
FAMILY-INITIATED ESCALATION;
PATIENT;
CARE;
D O I:
10.1136/jme-2023-109650
中图分类号:
B82 [伦理学(道德学)];
学科分类号:
摘要:
The UK government has recently committed to adopting a new policy-dubbed 'Martha's Rule'-which has been characterised as providing patients the right to rapidly access a second clinical opinion in urgent or contested cases. Support for the rule emerged following the death of Martha Mills in 2021, after doctors failed to admit her to intensive care despite concerns raised by her parents. We argue that framing this issue in terms of patient rights is not productive, and should be avoided. Insofar as the ultimate goal of Martha's Rule is the provision of a clinical service that protects patient safety, an approach that focuses on the obligations of the health system-rather than the individual rights of patients-will better serve this goal. We outline an alternative approach that situates rapid clinical review as part of a suite of services aimed at enhancing and protecting patient care. This approach would make greater progress towards addressing the difficult systemic issues that Martha's Rule does not, while also better engaging with the constraints of clinical practice.
机构:
UT Southwestern Med Ctr, Ctr Translat Med, Dept Clin Sci, Dallas, TX USAUT Southwestern Med Ctr, Ctr Translat Med, Dept Clin Sci, Dallas, TX USA
Holbein, M. E. Blair
Weatherwax, Kevin J.
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机构:
Univ Michigan, Michigan Inst Clin & Hlth Res MICHR, Ann Arbor, MI 48109 USAUT Southwestern Med Ctr, Ctr Translat Med, Dept Clin Sci, Dallas, TX USA
Weatherwax, Kevin J.
Gravelin, Misty
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机构:
Univ Michigan, Michigan Inst Clin & Hlth Res MICHR, Ann Arbor, MI 48109 USAUT Southwestern Med Ctr, Ctr Translat Med, Dept Clin Sci, Dallas, TX USA
Gravelin, Misty
Hutchinson, Raymond
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机构:
Univ Michigan, Med Sch, Michigan Med, Ann Arbor, MI 48109 USAUT Southwestern Med Ctr, Ctr Translat Med, Dept Clin Sci, Dallas, TX USA
Hutchinson, Raymond
Mashour, George A.
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机构:
Univ Michigan, Michigan Inst Clin & Hlth Res MICHR, Off Res, Ann Arbor, MI 48109 USAUT Southwestern Med Ctr, Ctr Translat Med, Dept Clin Sci, Dallas, TX USA