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重症监护病房伦理会诊的效果。

Effect of ethics consultations in the intensive care unit.

作者信息

Schneiderman Lawrence J

机构信息

Department of Family and Preventive Medicine and Department of Medicine, University of California School of Medicine, San Diego, California, USA.

出版信息

Crit Care Med. 2006 Nov;34(11 Suppl):S359-63. doi: 10.1097/01.CCM.0000237078.54456.33.

Abstract

Although evidence-based research is limited, results suggest that ethics consultations are associated with reductions in hospital days and intensive care unit days and in life-sustaining treatments in those patients who ultimately will not survive to discharge. Furthermore, the majority of healthcare providers and patients/surrogates agreed that ethics consultations in the intensive care unit were helpful in addressing treatment conflicts. Ethics consultations also reduce hospital costs without diminishing the quality of care. Hence, ethics consultations seem to be useful in resolving conflicts that may be inappropriately prolonging nonbeneficial or unwanted treatments at the end of life. Further research on whether ethics consultations are beneficial in other settings is needed to establish the optimal scope of this intervention. Also, the benefits described above were achieved by highly skilled and experienced consultants. It is not certain, therefore, how successful other hospitals will be when adopting this intervention.

摘要

尽管基于证据的研究有限,但结果表明,伦理会诊与缩短住院天数、重症监护病房天数以及减少最终无法存活至出院患者的维持生命治疗有关。此外,大多数医疗服务提供者和患者/代理人都认为,重症监护病房的伦理会诊有助于解决治疗冲突。伦理会诊还能降低医院成本,同时不降低护理质量。因此,伦理会诊似乎有助于解决那些可能不适当地延长临终时无益处或不必要治疗的冲突。需要进一步研究伦理会诊在其他环境中是否有益,以确定这种干预措施的最佳范围。此外,上述益处是由技术高超且经验丰富的会诊人员实现的。因此,其他医院采用这种干预措施时能否成功尚不确定。

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