Nortvedt Per, Kvarstein Gunnvald, Jønland Ingvild
Section for Medical Ethics, Faculty of Medicine, PO Box 1130 Blindern, University of Oslo, Oslo, Norway.
Nurs Ethics. 2005 Sep;12(5):522-36. doi: 10.1191/0969733005ne819oa.
This article focuses on the ethical aspects of medically-induced sedation and pain relief in intensive care medicine. The study results reported are part of a larger investigation of patients' experiences of being sedated and receiving pain relief, and also families' experiences of having a close relative under controlled sedation in an intensive care unit. The study is based on qualitative in-depth interviews with nine nurses and six doctors working in intensive care and surgical units in a major Norwegian hospital. The textual data are interpreted according to Kvale's method for analyzing qualitative data. There are ethical problems regarding how to achieve an acceptable balance between a patient's subjective well-being and the medical need for reduced sedation. The authors discuss whether some medical reasons for reduced sedation are ethically justifiable, given the actual medical knowledge available. The study also addresses the ethical consequences of reducing medically-induced sedation and the demands it puts on interdisciplinary co-operation and communication, as well as the importance of improving the quality of medical and nursing care.
本文聚焦于重症监护医学中药物诱导镇静和疼痛缓解的伦理问题。所报告的研究结果是对患者镇静和疼痛缓解体验以及家庭在重症监护病房中有近亲接受控制性镇静体验的一项更大规模调查的一部分。该研究基于对挪威一家大型医院重症监护和外科病房的九名护士和六名医生进行的定性深入访谈。文本数据根据克瓦尔分析定性数据的方法进行解读。在如何在患者主观幸福感与减少镇静的医疗需求之间实现可接受的平衡方面存在伦理问题。作者讨论了鉴于现有的实际医学知识，一些减少镇静的医学原因在伦理上是否合理。该研究还探讨了减少药物诱导镇静的伦理后果及其对跨学科合作与沟通的要求，以及提高医疗和护理质量的重要性。
