BACKGROUND & AIMS: :The progression from adolescence to adulthood is a time of tremendous change, characterized by issues of identity formation, autonomy, and shifting relationship dynamics. The family is embedded in all aspects of this transition and serves as both a protective support and a limiting factor, a complicated duality that raises psychological, ethical, and legal issues. This article discusses the influence of familial factors and provides assessment strategies for evaluating the family in relation to treatment of transitional age youth. It is increasingly evident that family engagement is a significant contributor to outcomes for transitional age youth seeking mental health treatment.

背景与目标： ：从青春期到成年是一个巨大的变化时期，其特征是身份形成，自主权和关系动态变化。家庭被嵌入到这种过渡的各个方面，既是保护性支持又是限制因素，复杂的二元性引发了心理，伦理和法律问题。本文讨论了家庭因素的影响，并提供了评估策略，以评估与过渡期青年治疗相关的家庭状况。越来越明显的是，家庭参与对寻求心理健康治疗的过渡年龄青年的结局做出了重要贡献。

BACKGROUND & AIMS: BACKGROUND::Patients' rights arise from their expectations of the healthcare system, which are rooted in their needs. Visitation is seen as a necessary need for patients and families in intensive care units. OBJECTIVES::The authors attempted to design, implement, and evaluate a new visiting policy in the intensive care units. RESEARCH DESIGN::This study was an action research, including two qualitative and quantitative approaches. PARTICIPANTS AND RESEARCH CONTEXT::The viewpoints of 51 participants (patients, families, doctors, nurses, and guards) on how to change the limited visiting policy were explained through semi-structured interviews and focus groups. The new visiting policy (contractual visitation) was designed, implemented, and evaluated with the involvement of participants. ETHICAL CONSIDERATIONS::The hospital ethics committee approval was gained and the informed consent was obtained from all the participants. FINDINGS::The content of interviews was analyzed and classified into four categories: advantages and disadvantages of visiting policies, and barriers and facilitators of changing the limited visiting policy. After implementation of the new policy (contractual visitation), a significant difference observed in satisfaction status before and after the changes (p value < 0.001). DISCUSSION::Nowadays, many countries' clinical guidelines recommend flexible visiting policy, which is consistent with the results of this study. CONCLUSION::Changing the limited visiting policy was a necessary need for patients and families that established with the involvement of them and staff.

背景与目标： 背景：患者的权利源自对医疗系统的期望，这种期望植根于他们的需求。在重症监护病房，探视被视为患者和家庭的必要需求。
目的：作者试图在重症监护病房设计，实施和评估一项新的就诊政策。
研究设计：：本研究是一项行动研究，包括定性和定量两种方法。
参与者和研究背景：通过半结构化访谈和焦点小组，对51位参与者（患者，家庭，医生，护士和护卫员）如何更改有限访问政策的观点进行了解释。在参与者的参与下，设计，实施和评估了新的访问政策（合同访问）。
道德考量：：获得了医院道德委员会的批准，并获得了所有参与者的知情同意。
结果：:访谈的内容被分析并分为四类：访问政策的优缺点，以及限制访问政策的障碍和促进者。实施新政策（合同探望）后，在变更前后的满意度之间存在显着差异（p值<0.001）。
讨论：：如今，许多国家/地区的临床指南建议采用灵活的就诊政策，这与本研究的结果一致。
结论：：改变有限的就诊政策是患者和家属在他们和员工参与下建立起来的必要需求。

BACKGROUND & AIMS: :Adverse drug events are common, especially in risk groups such as elderly persons. Many of the adverse drug events are preventable. The age-related changes in the different body functions have an impact on drug therapy: adjustments are required for the selection of drugs and dosages in elderly patients. Kidney function declines with age; as a consequence, drug excretion via the kidneys declines with increasing age. Also, the metabolic clearance of drugs that display a high hepatic extraction is reduced in elderly persons and the dosage of these drugs should be adapted. The present review summarizes the main findings related to the topic. Human beings make errors. Ensuring patient safety is a key issue. For elderly patients more information is required to establish a solid knowledge base. It is therefore necessary to include elderly patients in appropriate clinical trials in order to ensure that the necessary information can be accumulated.

背景与目标： ：药物不良反应很普遍，尤其是在老年人等高风险人群中。许多不良药物事件是可以预防的。与年龄有关的不同身体功能变化会影响药物治疗：老年患者的药物选择和剂量需要进行调整。肾功能随着年龄的增长而下降。结果，随着年龄的增长，通过肾脏排泄的药物减少。同样，显示出较高肝提取率的药物的代谢清除率在老年人中降低，因此应调整这些药物的剂量。本综述总结了与该主题有关的主要发现。人类会犯错误。确保患者安全是关键问题。对于老年患者，需要更多信息以建立扎实的知识库。因此，有必要将老年患者纳入适当的临床试验中，以确保可以收集必要的信息。

BACKGROUND & AIMS: BACKGROUND:Flame injury confers significant physical and psychologic stress on burn patients. Because most patients and their surrogates lack an understanding of burn injury, and these injuries preclude the meaningful exercise of patient autonomy, informed consent is a challenge for physicians. To better promote patient autonomy, this project collected patient perspectives on the proper duties of patients and physicians after severe burn injury and throughout the recovery phases. STUDY DESIGN:Ten survivors of severe burn injury were prospectively identified to represent different causes of injury, support systems, and socioeconomic backgrounds. Six persons participated (4 men, 2 women). Personal interviews with these individuals discussed their perspective and experience regarding physician and patient duties after severe burn injury as they relate to patient autonomy. RESULTS:All participants thought that informed consent was unrealistic at the time of their injury, but that this capacity developed over time as their understanding and level of functioning improved. In addition, all believed that the burn physicians' role was to do whatever was medically best for their patients in an emergency situation, but that this duty included the physician educating the patient or surrogates about what these treatments entail. CONCLUSIONS:Patient autonomy may be an unrealistic goal acutely for patients with severe burn injuries. Educational approaches to consent may facilitate patient autonomy, participation in decision making, and adherence to care plan over time. The ethical framework for this approach has been accepted in rehabilitation literature, but this is the first demonstration that relevant patient populations agree with this approach.

背景与目标： 背景：火焰伤害给烧伤患者带来巨大的生理和心理压力。由于大多数患者及其代理人缺乏对烧伤的理解，并且这些伤使患者无法自主行使有意义的自主权，因此，知情同意对医生来说是一个挑战。为了更好地促进患者的自主权，该项目收集了患者对严重烧伤后以及整个康复阶段患者和医生的适当职责的看法。
研究设计：前瞻性鉴定了十名严重烧伤的幸存者，他们代表不同的受伤原因，支持系统和社会经济背景。六人参加（4名男性，2名女性）。对这些人的个人访谈讨论了他们在严重烧伤后对医师和患者职责的看法和经验，因为它们与患者的自主权有关。
结果：所有参与者都认为受伤时知情同意是不现实的，但是随着他们的理解和功能水平的提高，这种能力随着时间的推移而发展。此外，所有人都认为烧伤医师的作用是在紧急情况下尽其所能为患者做最适合自己的药物，但是这项职责包括医师对患者进行教育或对这些疗法的含义进行替代。
结论：对于重度烧伤患者，患者自主性可能是一个不切实际的目标。同意的教育方法可以促进患者的自主权，参与决策以及随着时间的推移遵守护理计划。康复文献已经接受了这种方法的伦理框架，但这是有关患者人群同意这种方法的第一个证明。

BACKGROUND & AIMS: OBJECTIVE:To explore social equity, health planning, regulatory and ethical dilemmas in responding to a pandemic influenza (H5N1) outbreak, and the adequacy of protocols and standards such as the International Health Regulations (2005). APPROACH:This paper analyses the role of legal and ethical considerations for pandemic preparedness, including an exploration of the relevance of cross-jurisdictional and cross-cultural perspectives in assessing the validity of goals for harmonisation of laws and policies both within and between nations. Australian and international experience is reviewed in various areas, including distribution of vaccines during a pandemic, the distribution of authority between national and local levels of government, and global and regional equity issues for poorer countries. CONCLUSION:This paper finds that questions such as those of distributional justice (resource allocation) and regulatory frameworks raise important issues about the cultural and ethical acceptability of planning measures. Serious doubt is cast on a 'one size fits all' approach to international planning for managing a pandemic. It is concluded that a more nuanced approach than that contained in international guidelines may be required if an effective response is to be constructed internationally. IMPLICATIONS:The paper commends the wisdom of reliance on 'soft law', international guidance that leaves plenty of room for each nation to construct its response in conformity with its own cultural and value requirements.

背景与目标： 目的：探讨应对大流行性流感（H5N1）暴发时的社会公平性，卫生计划，监管和道德困境，以及《国际卫生条例（2005）》等协议和标准的充分性。
方法：本文分析了大流行防范的法律和道德考虑因素的作用，包括探讨跨司法管辖区和跨文化的观点在评估国家内部和国家之间协调法律和政策目标的有效性方面的相关性。对澳大利亚和国际经验的各个方面进行了回顾，包括大流行期间疫苗的分配，国家和地方政府之间的权限分配以及较贫穷国家的全球和区域公平问题。
结论：本文发现诸如分配正义（资源分配）和监管框架等问题提出了有关计划措施的文化和伦理可接受性的重要问题。在应对流感大流行的国际规划中，“一刀切”的做法令人严重怀疑。结论是，如果要在国际上作出有效的反应，可能需要比国际准则中所包含的方法更细微的方法。
启示：本文赞扬了依赖“软法”的智慧，国际法为每个国家留出了足够的空间来根据自己的文化和价值要求来构建其应对措施。

BACKGROUND & AIMS: :Using ethnographic material collected between 2003 and 2007 in five HIV clinics in the US, South Africa, Uganda, and Thailand, this article examines "official ethics" and "ethics on the ground." It compares the ethical conundrums clinic staff and researchers confront in their daily work as HIV researchers with the dilemmas officially identified as ethical issues by bioethicists and people responsible for ethics reviews and compliance with ethics regulations. The tangled relation between ethical problems and solutions invites a comparison to Rittel and Webber's "wicked problems." Official ethics' attempts to produce universal solutions often make ethics problems even more wickedly intractable. Ethics on the ground is in part a reaction to this intractability.

背景与目标： ：本文使用在2003年至2007年之间在美国，南非，乌干达和泰国的五个HIV诊所收集的人种志资料，研究了“官方伦理”和“实地伦理”。它比较了作为艾滋病病毒研究人员的诊所工作人员和研究人员在日常工作中面临的伦理难题，以及由生物伦理学家和负责伦理审查并遵守伦理法规的人员正式确定为伦理问题的困境。道德问题与解决方案之间的纠结关系使我们可以将其与Rittel和Webber的“邪恶问题”进行比较。官方道德规范试图产生普遍解决方案，常常使道德规范问题变得更加棘手。实地道德在某种程度上是对这种顽固性的反应。

BACKGROUND & AIMS: :The dilemma of whether or not a doctor should tell a patient dying of cancer the truth remains a difficult one, as the disagreement between the two previous writers shows. One favours giving priority to patient autonomy, the other feels the doctor's duty of beneficence should be the overriding principle governing such decisions. To this contributor it seems both approaches have something to offer. By being sensitive to what and how much the patient wishes to know and by learning from the insights provided by the study of medical ethics, doctors can learn how to make better moral decisions in this and in other areas. Both lying and truth-telling carry risks of harm to the patient. Learning to work with and balance these risks is part of clinical practice. So is minimising risks by clear thinking.

背景与目标： ：正如前两位作家之间的分歧所表明的那样，医生是否应该告诉癌症死者这个事实的困境仍然是一个难题。一个人主张优先考虑患者的自主权，另一个人则认为医生的仁慈义务应是支配此类决定的首要原则。对于该贡献者而言，似乎两种方法都可以提供一些东西。通过对患者希望了解的知识和知识多少敏感，以及通过从医学伦理学研究中获得的见识中学习，医生可以学习如何在此领域和其他领域做出更好的道德决定。说谎和讲真话都有给患者带来伤害的风险。学会与这些风险一起工作和平衡这些风险是临床实践的一部分。通过清晰的思维将风险最小化也是如此。

BACKGROUND & AIMS: :This paper argues that the central issue in the abortion debate has not changed since 1967 when the English parliament enacted the Abortion Act. That central issue concerns the moral status of the human fetus. The debate here is not, it is argued, primarily a moral debate, but rather a metaphysical debate and/or a theological debate--though one with massive moral implications. It concerns the nature and attributes that an entity requires to have "full moral standing" or "moral inviolability" including a "right to life". It concerns the question when, in its development from newly fertilised ovum to unequivocally mature, autonomous morally inviolable person does a human being acquire that nature and those attributes, and thus a "right to life". The paper briefly reviews standard answers to these questions, outlining some problems associated with each. Finally there is a brief discussion of one way in which the abortion debate has changed since 1967--notably in the increasingly vociferous claim, especially from disability rights sectors, that abortion on grounds of fetal abnormality implies contempt for and rejection of disabled people--a claim that is rebutted.

背景与目标： ：本文认为，自1967年英国议会制定《堕胎法》以来，堕胎辩论的中心问题一直没有改变。这个中心问题涉及人类胎儿的道德状况。它认为这里的辩论不是主要的道德辩论，而是形而上学辩论和/或神学辩论，尽管这具有重大的道德含义。它涉及一个实体具有“充分的道德地位”或“道德不可侵犯性”（包括“生命权”）所需的性质和属性。它涉及一个问题，即在从新受精的卵子发展到毫无疑问的成熟时，自主的，在道德上不受侵犯的人使人获得了这种性质和那些属性，从而获得了“生命权”。本文简要回顾了这些问题的标准答案，概述了与每个问题相关的一些问题。最后，简要讨论了自1967年以来堕胎辩论发生变化的一种方式-尤其是在越来越多的争吵声中，尤其是在残疾人权利部门，这种说法以胎儿畸形为由进行堕胎意味着轻视和拒绝残疾人。被驳回的主张。

BACKGROUND & AIMS: :Technology advances in medicine have led to increased usage of smartphones and applications in facilitating provision of care. As the increased power of technology paves the way for advances, it is fundamental that ethical considerations are comprehensively explored. This paper explores the importance of consent, confidentiality, and data security in use of smartphone applications for transferring medical information.

背景与目标： ：医学技术的进步导致智能手机和应用程序的使用增加，从而促进了医疗服务的提供。随着技术力量的增强为进步铺平了道路，全面探讨道德考量是至关重要的。本文探讨了在使用智能手机应用程序传输医疗信息时同意，机密性和数据安全性的重要性。

BACKGROUND & AIMS: :Potential ethical issues and challenges to professionalism arise commonly in the care of patients with psychiatric illnesses. As such, education and training in medical ethics especially as applied to psychiatry and professionalism should be offered to trainees during the formative years of residency and fellowship. This article proposes a curriculum for senior residents and fellows that uses a case-centred seminar to discuss ethical dilemmas, approaches to analysing ethical issues, and to develop a course of action for resolution. Representative ethical issues and the clinical arenas in which these are most likely to arise are suggested.

背景与目标： ：潜在的道德问题和对专业精神的挑战通常出现在患有精神疾病的患者的护理中。因此，在居住和团契的成长阶段，应向受训者提供医学伦理方面的教育和培训，尤其是应用于精神病学和专业精神的教育和培训。本文提出了一个针对高龄居民和进修生的课程，该课程使用以案例为中心的研讨会来讨论道德困境，分析道德问题的方法并制定解决方案。建议了最有可能出现的代表性伦理问题和临床领域。

BACKGROUND & AIMS: :Oral health encompasses dentistry and is broader in concept. Dentistry alone appears insufficient to ensure oral health for the population at large. Troubling disparities in oral health status and access to care have been documented. The segment of the population that has little or no access to care is growing; aging baby-boomers are adding to this problem. As suggested in Oral Health in America: A Report of the Surgeon General, partnerships and collaboration are essential to improving oral health. The ethics of dental practice and the profession are being called into question. Who will provide the necessary leadership to address and resolve these issues, so that oral health is attainable by all?

背景与目标： ：口腔健康包括牙科，并且在概念上更广泛。牙科本身似乎不足以确保整个人群的口腔健康。口腔健康状况和获得护理方面的令人不安的差距已被记录在案。很少或根本没有获得医疗服务的人口比例正在增长；婴儿潮一代的衰老加剧了这个问题。正如《美国口腔卫生：外科医生报告》中所建议的那样，建立伙伴关系和合作对改善口腔健康至关重要。牙科实践和职业道德被质疑。谁将提供必要的领导才能解决和解决这些问题，以便所有人都能获得口腔健康？

BACKGROUND & AIMS: BACKGROUND:Neurocognitive deficits from brain tumours may impair the ability to safely operate a motor vehicle. Although certain jurisdictions in Canada legally require that physicians report patients who are unfit to drive, criteria for determining fitness are not clearly defined for brain tumours. METHODS:Patients receiving brain radiotherapy at our institution from January to June 2009 were identified using the Oncology Patient Information System. In addition to descriptive statistics, details of driving assessment were reviewed retrospectively. The Fisher exact test was used to determine factors predictive of reporting a patient to the Ontario Ministry of Transportation (mto) as unfit to drive. A logistic regression model was constructed to further determine factors predictive of reporting. RESULTS:Of the 158 patients available for analysis, 48 (30%) were reported to the mto, and 64 (41%) were advised to stop driving. With respect to the 53 patients with seizures, a report was submitted to the mto for 30 (57%), and a documented discussion about the implications of driving was held with 35 (66%). On univariate analysis, younger age, a central nervous system primary, higher brain radiotherapy dose, unifocal disease, and the presence of seizures were predictive of physician reporting (p < 0.05). On logistic regression modelling, the presence of seizures (odds ratio: 3.9) and a higher radiotherapy dose (odds ratio: 1.3) remained predictive of reporting. INTERPRETATION:Physicians frequently do not discuss the implications of driving with brain tumour patients or are not properly documenting such advice (or both). Clear and concise reporting guidelines need to be drafted given the legal, medical, and ethical concerns surrounding this public health issue.

背景与目标： 背景：脑肿瘤的神经认知功能缺陷可能会损害安全操作机动车的能力。尽管加拿大的某些司法管辖区在法律上要求医师报告不适合驾驶的患者，但尚无明确确定适合脑部肿瘤的确定标准。
方法：使用肿瘤学患者信息系统对2009年1月至2009年6月在我院接受脑放疗的患者进行鉴定。除了描述性统计数据之外，还对驾驶评估的细节进行了回顾性审查。 Fisher精确检验用于确定预测将患者报告给安大略省交通运输部（mto）不适合驾驶的因素。构建了逻辑回归模型以进一步确定预测报告的因素。
结果：在158例可进行分析的患者中，有48例（30％）被报告到mto，建议64例（41％）停止驾驶。对于53例癫痫发作患者，有30例（57％）报告给了MTO，有35例（66％）对驾驶的影响进行了书面讨论。单因素分析显示，年龄较小，原发性中枢神经系统，较高的脑放疗剂量，单灶性疾病和癫痫发作可预示医生的报告（p <0.05）。在逻辑回归模型中，癫痫发作（比值：3.9）和更高的放疗剂量（比值：1.3）的存在仍然可以预测报告。
解释：医师经常不讨论与脑肿瘤患者一起驾驶的含义，或者没有适当地记录这样的建议（或两者皆有）。考虑到围绕此公共卫生问题的法律，医学和道德问题，需要起草清晰，简明的报告指南。

BACKGROUND & AIMS: :The three primary ethical challenges in preparing for public health emergencies - addressing questions of rationing, restrictions and responsibilities - all entail confronting uncertainty. But the third, considering whether people and institutions will live up to their responsibilities in a crisis, is perhaps the hardest to predict and therefore plan for. The quintessential example of a responsibility during a public health emergency is that of health care professionals' obligation to continue caring for patients during epidemics. Historically, this 'duty to treat' has sometimes gone unrecognized or ignored, but it has also famously been adhered to, including during the recent SARS epidemic. And non-crisis examples of health professionals working in the face of personal risk are very common. The duty to treat should be circumscribed by several considerations, including the levels or risk and benefit at issue, the degree of public reliance on health professional action, and the nature of the individual health professional's acceptance of greater than usual risk. Examining the professional duty to treat and the legitimate questions it raises can provide insight into other actors' responsibilities. Public health ethics as well as professional ethics can help frame answers to some key questions: How strong are ethical responsibilities during crises? To whom do they apply? Should they be more explicit - and hence more circumscribed - or less explicit and hence largely aspirational? And how can public health policies encourage responsible actions?

背景与目标： ：在应对突发公共卫生事件时，面临的三个主要的道德挑战-解决配给，限制和责任问题-都面临不确定性。但是考虑到人和机构在危机中是否能履行自己的职责，第三点也许是最难预测和计划的。突发公共卫生事件中最典型的责任示例是卫生保健专业人员在流行病期间继续照顾患者的义务。从历史上看，这种“治疗义务”有时未被认识或忽略，但在最近的SARS流行期间也一直坚持执行。面对个人风险的卫生专业人员的非危机案例非常普遍。治疗的责任应由几个考虑因素来界定，包括所考虑的水平或风险和利益，公众对卫生专业人员行为的依赖程度以及个人卫生专业人员接受比平常更大的风险的性质。审视治疗的专业责任及其提出的合理问题，可以洞悉其他行为者的责任。公共卫生道德规范和职业道德规范可以帮助回答一些关键问题：危机期间的道德责任有多强？他们向谁申请？他们应该更明确-从而受到更多限制-还是不那么明确并因此大有抱负？公共卫生政策如何鼓励采取负责任的行动？

BACKGROUND & AIMS: :A pilot study was undertaken in the UK in February 2005 to identify the perceptions of risk, effectiveness and ethicality of different hypothetical transfusion options, including blood substitutes derived from different sources, among young adults. Forty-nine men and 92 women completed the questionnaire, aging between 18 and 25 years old (mean +/- standard deviation = 19.7 +/- 1.2 years). Twenty-three percent of respondents had donated blood, an average of 3.1 times. The study assessed the perceptions of donor blood versus 3 different types of potential "artificial blood" [i.e. "chemical" (synthetic), "grown from bacteria" (recombinant hemoglobin), or "based on cow blood" (bovine hemoglobin)] on three dimensions, namely risk, effectiveness, and ethicality, each scored on a 1 (least) to 7 (most) Likert-type scale. Donor blood was rated as significantly (P < 0.05) less risky, more effective and more ethical than any of the blood substitutes. The chemical-based blood substitute was rated second least risky, second most effective and second most ethical followed by bacteria grown substitute. The bovine-based blood substitute was rated as significantly riskier, least effective and least ethical. All the blood products differed significantly for perceived ethicality, with donor blood considered as most ethical and a blood substitute derived from bovine blood as least ethical. Judgments of risk correlated negatively with effectiveness (all transfusion options) and ethicality (all the blood substitutes). Overall, these results indicate that donor blood is currently preferred over blood substitutes in the UK and that judgments of risk about different hypothetical transfusion options are related to perceptions of effectiveness and ethicality.

背景与目标： ：2005年2月在英国进行了一项试点研究，以识别年轻人中不同的假设性输血选择（包括来自不同来源的血液替代品）的风险，有效性和道德观念。问卷中有49位男性和92位女性，年龄在18至25岁之间（平均/标准差= 19.7 /-1.2岁）。 23％的受访者献血，平均为3.1倍。这项研究评估了供血与3种不同类型的潜在“人工血”的认知度。 “化学”（合成），“从细菌中生长”（重组血红蛋白）或“基于牛血”（牛血红蛋白）]在三个方面进行评估，即风险，有效性和道德标准，每个方面的得分为1（最低）至7（最）李克特式量表。与其他血液替代品相比，献血者的危险性，有效性和道德性均显着降低（P <0.05）。基于化学的血液替代品被评为风险第二低，第二有效和伦理第二高，其次是细菌替代品。以牛为基础的血液替代品被评为具有较高的危险性，最无效和最不道德的标准。所有血液产品在伦理道德上都存在显着差异，其中捐献者血液被认为是最道德的，而从牛血液中获得的血液替代品则被认为是最不道德的。风险判断与有效性（所有输血选择）和道德（所有血液替代品）负相关。总体而言，这些结果表明，在英国，目前供血者的血液优先于血液替代品，并且关于不同的假设输血选择的风险判断与对有效性和道德的看法有关。

BACKGROUND & AIMS: :This paper explores some of the ethical considerations of working collaboratively with people with dementia within research based upon the experiences, challenges and learning from three doctoral research studies. Focus is on the research relationship with participants and gatekeepers, the importance of setting and access, the power relations within the research and ways in which people with dementia can be supported to be active and have a voice in research. This sits within an ethical framework of principalist ethics and ethics of care to guide not only how research is planned ethically and with consideration of participants, but also how this can support decisions made in situ. The aim is to share, based upon these three studies, ways of managing and working through some of the ethical consideration to support researchers in their decisions in planning and conducting research with people with dementia as active collaborators.

背景与目标： ：本文基于三项博士研究的经验，挑战和学习，探讨了在研究中与痴呆症患者合作的一些伦理学考虑。重点是与参与者和看门人之间的研究关系，设置和访问的重要性，研究中的权力关系以及可以支持痴呆症患者活跃并在研究中发表意见的方式。这位于原则主义伦理和关怀伦理的伦理框架之内，不仅可以指导研究如何在伦理上进行计划并在考虑参与者的情况下进行指导，而且还可以指导研究如何支持就地决策。目的是在这三项研究的基础上，共享管理和解决某些道德问题的方法，以支持研究人员在与痴呆症患者作为积极合作者的计划和进行研究的决策中进行决策。