Silfen E
Reston Hospital Center, VA.
J Health Hosp Law. 1995 Jan-Feb;28(1):21-8.
Paralleling the expansion of the complexity of our society, medical decision making has become intensely intricate. Given this technological explosion that geometrically multiplied the possibilities and nuances of end-of-life decisions, the processes for making fully informed decisions became overwhelmed. The interest in end-of-life, medical decisions encompasses the patient, his or her physicians and family, health care administrators, and all parties engaged in protecting the public welfare. At one narrow window in time all parties must have a clear, personal understanding of: 1) the importance and meaning of informed consent; 2) the content of and process for advance directives; 3) the legal status of patient surrogates; 4) the economic issues involved in medical care; 5) the circumstances surrounding medical futility; 6) the spectrum of euthanasia; and 7) the perception of panic at the moment of acute emergency. For the patient and those who care, it is only when these concepts gel that the toughest decisions one will ever have to make can become conceivable.
随着我们社会复杂性的不断扩展，医疗决策变得极其错综复杂。鉴于这场技术爆炸，它让临终决策的可能性和细微差别呈几何级数增长，做出充分知情决策的过程变得不堪重负。对临终医疗决策的关注涉及患者、其医生和家人、医疗保健管理人员以及所有参与保护公众福利的各方。在某个特定的时间窗口，所有各方都必须对以下内容有清晰、个人化的理解：1）知情同意的重要性和意义；2）预先指示的内容和程序；3）患者代理人的法律地位；4）医疗护理中涉及的经济问题；5）医疗无效的相关情况；6）安乐死的范围；7）急性紧急情况下的恐慌感。对于患者及其护理人员而言，只有当这些概念融会贯通时，人们不得不做出的最艰难决策才有可能被设想出来。
