309 KB22 KB200820252017Šavrin, Rajmondletnik:16str. 127-131številka:supl. 1ISSN:1580-9315COBISSID_HOST:2310249URN:URN:NBN:SI:doc-QWOENL57slUniverzitetni rehabilitacijski inštitut Slovenije - SočaRehabilitacija (Ljubljana)ethical issuesEthicsetične dilemeokvara hrbtenjačeparaplegiaparaplegijarehabilitacijarehabilitationSpinal Cord Injuriesvocational rehabilitationEtične dileme pri rehabilitaciji bolnikov po okvari hrbtenjače| Ethical dilemmas in rehabilitation of patients after spinal cord lesion|The most important ethical dilemmas in the rehabilitation of patients after spinal cord lesion at the University Rehabilitation Institute in Ljubljana are of three types: (1) dilemmas in carrying out triage and prioritising admission of patients regardless of their current health status and ability to actively participate in the programs of complex medical rehabilitation; (2) dilemmas regarding the acceptance or rejection of severely handicapped patients with traumatic spinal cord injury to the upper cervical areas and the need for artificial ventilation; and (3) dilemmas regarding the isolation of patients with multi resistant microorganisms and the related issue of the adequacy of the quantity and quality of provided rehabilitation program. Due to limited staff and technical options at our Institute, there is presently no possibility to provide professional and safe care for patients with traumatic spinal cord injury who are dependent on artificial ventilation. It is necessary to improve the possibilities for long-term acute care of patients in intensive care departments, which ensure continuity of supervision by medical staff, and to regulate the final destination of those patients. The problems of such patients do not yet pose significant ethical dilemmas to the relevant national authorities in the sense that they would appropriately regulate early medical care, rehabilitation program (if feasible) and the final lifetime destination in an appropriate social institution for such patientsNajpomembnejše etične dileme pri rehabilitaciji bolnikov po okvari hrbtenjače na Univerzitetnem rehabilitacijskem inštitutu Republike Slovenije - Soča so dileme pri izvajanju triaže in določanju vrstnega reda sprejemanja bolnikov glede na njihovo trenutno zdravstveno stanje in sposobnost za aktivno sodelovanje v programih kompleksne medicinske rehabilitacije, dileme glede sprejemanja ali zavračanja najtežje prizadetih bolnikov s poškodbeno okvaro hrbtenjače zgornjih vratnih predelov in potrebo po umetnem predihavanju ter dileme glede osamitve bolnikov z večkrat odpornimi mikroorganizmi ter s tem povezanim vprašanjem o ustreznosti količine in kakovosti nudenega rehabilitacijskega programa. Zaradi omejenih kadrovskih in tehničnih možnosti na Univerzitetnem rehabilitacijskem inštitutu Republike Slovenije - Soča za zdaj ni možnosti za nudenje strokovno varne oskrbe bolnikov s poškodbeno okvaro hrbtenjače in potrebo po umetnem predihavanju. Potrebno je izboljšati možnosti za daljšo akutno oskrbo teh bolnikov na travmatoloških intenzivnih oddelkih, kjer je zagotovljen stalni nadzor s strani zdravstvenega osebja ter urediti njihovo končno namestitev. Težave teh bolnikov še ne predstavljajo velike etične dileme ustreznim državnim organom, da bi se primerneje uredila zgodnja travmatološka oskrba, morebitna rehabilitacija, če bi bili bolniki zanjo sposobni, kot tudi končna doživljenjska namestitev v ustrezni socialni ustanoviTEXTznanstveno časopisjejournalsSlovenian National E-content AggregatorNational and University Library of SloveniaUniverzitetni rehabilitacijski inštitut RS – Soča