临床决策的边界

探讨临床决策之边界,以期为临床医生合理决策提供参考。临床决策是日常医疗工作的核心内容,医生是临床决策的制定者和施行者。决策过程中,医生需综合考量多种因素,如病人的临床状况和真正需要解决的临床问题、法律法规、伦理和社会因素、诊疗规范和指南、经验总结、个案和基础研究、团队的技术能力、专业标准和临床预期等,这些因素组成了临床决策的基本边界,同时,这个边界会随着医学、文化、经济、社会的发展而变化。

Boundary of Clinical Decision-making

This paper aims to discuss the boundary of clinical decision-making as a reference to clinician's rational thinking.Clinical decision-making is the core of daily clinical work.Clinicians are the designers and implementers of clinical decisionmaking.In the process of decision-making,clinicians have to consider a variety of factors,such as patients' real clinical condition,laws,ethics,social factors,rules of diagnosis and treatment,experience,case reports,basic research,technology,professional standard and clinical outcomes,etc.,which constitute the basic boundary of clinical decisionmaking.This boundary will change with the development of medicine,culture,economy and society.