Sachs G A
Section of General Internal Medicine, University of Chicago.
Oncology (Williston Park). 1992 Feb;6(2 Suppl):131-5.
There are no simple solutions to difficult ethical problems. Advance directives, however, offer a way to help prevent ethical dilemmas from occurring in the care of older cancer patients. Studies show that there is overwhelming support from both older patients and physicians for advance treatment planning through the use of living wills, durable powers of attorney for health care, and less formal means. Despite this support, few physicians and patients discuss advance directives. This paper discusses potential barriers to this dialogue and suggests specific ways to incorporate advance directive into routine cancer care of older patients. The Patient Self-Determination Act of 1990 represents additional pressure from society on the medical profession to carry out advance directive discussions.
对于棘手的伦理问题，没有简单的解决方案。然而，预先指示提供了一种方法，有助于防止在老年癌症患者的护理中出现伦理困境。研究表明，老年患者和医生都压倒性地支持通过使用生前遗嘱、医疗保健持久授权书以及不太正式的方式来进行预先治疗规划。尽管有这种支持，但很少有医生和患者讨论预先指示。本文讨论了这种对话的潜在障碍，并提出了将预先指示纳入老年患者常规癌症护理的具体方法。1990年的《患者自主决定法案》代表了社会对医疗行业进行预先指示讨论的额外压力。
