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预立医疗指示、自主权与意外死亡

Advance directives, autonomy and unintended death.

作者信息

Stone Jim

出版信息

Bioethics. 1994 Jul;8(3):223-46. doi: 10.1111/j.1467-8519.1994.tb00256.x.

Abstract

This paper argues that living wills are typically nebulous and confused documents that do not effectively enable you to determine your future treatment. Worse, signing a living will can end your life in ways you never intended, long before you are either incompetent or terminally ill. This danger is compounded by the fact that those who implement living wills are often themselves dangerously confused, so that, for example, they cannot be relied upon to distinguish living wills from DNR orders. In addition, the paper argues that advance directives concerning resuscitation are often so confused that they end the lives of healthy, alert people who have not suffered cardiac or pulmonary arrest. Finally, the paper argues that advance directives establishing durable power of attorney for health care often preserve the chief dangers of living wills. Suggestions are offered as to how you can most effectively direct your future treatment without endangering your life.

摘要

本文认为,生前遗嘱通常是模糊不清、令人困惑的文件,无法有效地让你决定未来的治疗方式。更糟糕的是,签署生前遗嘱可能会以你从未预料到的方式结束你的生命,远在你丧失行为能力或身患绝症之前。这种危险因以下事实而加剧:执行生前遗嘱的人自身往往也极度困惑,以至于例如,无法指望他们区分生前遗嘱和“不要复苏”指令。此外,本文认为关于心肺复苏的预先指示往往如此混乱,以至于它们结束了那些没有遭受心脏或肺部骤停的健康、警觉之人的生命。最后,本文认为设立医疗保健持久授权书的预先指示往往保留了生前遗嘱的主要危险。文中还就如何在不危及生命的情况下最有效地指导你未来的治疗提供了建议。

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