Ackermann R J
Mercer University School of Medicine, Macon, Georgia 31206, USA.
Am Fam Physician. 2000 Oct 1;62(7):1555-60, 1562, 1564.
Withholding or withdrawing life-sustaining therapies is ethical and medically appropriate in some circumstances. This article summarizes the American Medical Association's Education for Physicians on End-of-life Care (EPEC) curriculum module on withholding or withdrawing therapy. Before reviewing specific treatment preferences, it is useful to ask patients about their understanding of the illness and to discuss their values and general goals of care. Family physicians should feel free to provide specific advice to patients and families struggling with these decisions. Patients with decision-making capacity can opt to forego any medical intervention, including artificial nutrition/hydration and cardiopulmonary resuscitation.
在某些情况下, withhold 或 withdraw 维持生命的治疗是符合伦理且在医学上恰当的。本文总结了美国医学协会关于临终关怀的医生教育(EPEC)课程模块中关于 withhold 或 withdraw 治疗的内容。在审查具体的治疗偏好之前,询问患者对疾病的理解并讨论他们的价值观和总体护理目标是很有用的。家庭医生应随时为在这些决策中挣扎的患者和家属提供具体建议。有决策能力的患者可以选择放弃任何医疗干预,包括人工营养/水分补充和心肺复苏。