医务社工介入“三无”病人救助的伦理困境研究

Study on the Ethical Dilemma of Medical Social Workers’ Involvement in the Relief of “Three-Nothing” Patients

摘要: 近些年来，医务社会工作在沿海发达城市迅猛发展，医务社工已成为一种新兴职业，这一全新的工作领域为病人及其家属提供全方位的人性化服务。发源于西方国家的社会工作，在中国本土化实践过程中面临着众多伦理困境，在医务社工领域体现得尤为明显。“三无”患者由于没有家属陪伴、缺少医疗费用以及没有安置之所等原因，呈现出多种问题。本研究以医务社工介入“三无”病人救助的服务案例为例，梳理发现医务社工介入“三无”病人的过程中，面临生命至上与知情同意、案主自决与资源有限等方面的伦理困境。面对这些挑战，提出包括遵守伦理原则，规范工作程序；整合社会资源，构建合作团队以及加强舆论宣传和采取正确态度等一系列建议。这些建议旨在帮助医务社工更好地应对伦理困境，提高服务质量，同时也为未来的实务和研究提供参考。

Abstract: In recent years, medical social work has been developing rapidly in developed coastal cities, and medical social work has become a new profession, a brand new field of work that provides a full range of humane services for patients and their families. This new field of work provides comprehensive and humane services to patients and their families. Social work, which originated in western countries, faces many ethical dilemmas in the process of localisation in China, which are particularly evident in the field of medical social work. The “three-nothing” patients present a variety of problems due to the lack of family members to accompany them, the lack of medical expenses, and the lack of a place to live. This study takes the case of medical social workers intervening in the assistance of the “three-nothing” as an example, and finds that in the process of intervening in the process of the “three-nothing”, medical social workers are faced with ethical dilemmas in the areas of the primacy of life and informed consent, the self-determination of the caseworker, and the limitation of resources. In the face of these challenges, a series of recommendations are put forward, including the observance of ethical principles and standardisation of work procedures, the integration of social resources, the construction of cooperative teams, and the strengthening of public opinion and the adoption of correct attitudes. These recommendations aim to help MSWs better cope with ethical dilemmas and improve the quality of their services, as well as provide references for future practice and research.