Breier-Mackie S
School of Medicine, Discipline of General Practice, University of Tasmania, PO Box 252-33, Hobart, Tasmania 7001, Australia.
Nurs Ethics. 2001 Nov;8(6):510-21. doi: 10.1177/096973300100800605.
Nurses are increasingly faced with situations in practice regarding the prolongation of life and withdrawal of treatment. They play a central role in the care of dying people, yet they may find themselves disempowered by medical paternalism or ill-equipped in the decision-making process in end-of-life situations. This article is concerned with the ethical relationships between patient autonomy and medical paternalism in end-of-life care for an advanced cancer patient. The nurse's role as the patient's advocate is explored, as are the differences between nursing and medicine when confronted with the notion of patient autonomy. The impetus for this discussion stems from a clinical encounter described in the following scenario.
护士在实践中越来越多地面临与延长生命和停止治疗相关的情况。他们在照顾临终患者方面发挥着核心作用,但在临终情况下,他们可能会发现自己因医疗家长主义而丧失权力,或者在决策过程中准备不足。本文关注晚期癌症患者临终护理中患者自主权与医疗家长主义之间的伦理关系。探讨了护士作为患者代言人的角色,以及面对患者自主权概念时护理与医学之间的差异。这场讨论的推动力源于以下情景中描述的一次临床遭遇。