在美国，对重症患者停止或撤销维持生命治疗的压力。
The pressure to withhold or withdraw life-sustaining therapy from critically ill patients in the United States.
作者信息
Luce John M, White Douglas B
机构信息
Division of Pulmonary and Critical Care Medicine, San Francisco General Hospital, 1001 Potrero Avenue, Room 5 K1, San Francisco, CA 94110, USA.
出版信息
Am J Respir Crit Care Med. 2007 Jun 1;175(11):1104-8. doi: 10.1164/rccm.200609-1397CP. Epub 2007 Mar 22.
Abstract
Physicians and nurses sometimes exert pressure on the families of critically ill patients to withhold or withdraw life-sustaining therapy from them. This pressure may stem from prognostic, professional, social, and economic factors. Although the pressure to limit life support may be appropriate in some circumstances, in others it is not justified. The pressure also may damage communications and cause resentment. If communications cannot be improved, and if the pressure cannot be relieved, a due process approach to conflict resolution that involves other parties may be required.
摘要
医生和护士有时会向重症患者的家属施压，要求他们对患者停止或撤销维持生命的治疗。这种压力可能源于预后、专业、社会和经济等因素。尽管在某些情况下限制生命支持的压力可能是合理的，但在其他情况下则不然。这种压力还可能破坏沟通并引发怨恨。如果沟通无法改善，压力无法缓解，可能需要采用一种涉及其他各方的正当程序来解决冲突。
相似文献
1
The pressure to withhold or withdraw life-sustaining therapy from critically ill patients in the United States.
Am J Respir Crit Care Med. 2007 Jun 1;175(11):1104-8. doi: 10.1164/rccm.200609-1397CP. Epub 2007 Mar 22.
2
Physicians' decisions to withhold and withdraw life-sustaining treatment.
Arch Intern Med. 2006 Mar 13;166(5):560-4. doi: 10.1001/archinte.166.5.560.
3
Decision-Making on Withholding or Withdrawing Life Support in the ICU: A Worldwide Perspective.
Chest. 2017 Aug;152(2):321-329. doi: 10.1016/j.chest.2017.04.176. Epub 2017 May 5.
4
Physician Approaches to Conflict with Families Surrounding End-of-Life Decision-making in the Intensive Care Unit. A Qualitative Study.
Ann Am Thorac Soc. 2018 Feb;15(2):241-249. doi: 10.1513/AnnalsATS.201702-105OC.
5
Families and the decision to withhold or withdraw life-sustaining therapy from the critically ill: are pressure tactics ever justified?
Am J Respir Crit Care Med. 2008 Jan 1;177(1):124. doi: 10.1164/ajrccm.177.1.124.
6
Forgoing life-sustaining treatments: comparison of attitudes between Israeli and North American intensive care healthcare professionals.
Isr Med Assoc J. 2003 Nov;5(11):770-4.
7
The Association Between the Decision to Withdraw Life-Sustaining Therapy and Patient Mortality in U.K. ICUs.
Crit Care Med. 2022 Apr 1;50(4):576-585. doi: 10.1097/CCM.0000000000005306.
8
End-of-life decision-making in critically ill old patients with and without coronavirus disease 2019.
Acta Anaesthesiol Scand. 2024 Jan;68(1):63-70. doi: 10.1111/aas.14326. Epub 2023 Sep 5.
9
Achieving consensus on withdrawing or withholding care for critically ill patients.
J Gen Intern Med. 1992 Sep-Oct;7(5):475-80. doi: 10.1007/BF02599446.
10
Toleration of moral diversity and the conscientious refusal by physicians to withdraw life-sustaining treatment.
J Med Philos. 1994 Apr;19(2):147-59. doi: 10.1093/jmp/19.2.147.
引用本文的文献
1
Subdural hematoma complicated by seizures and prolonged neurological decline: An ethical management dilemma.
Surg Neurol Int. 2025 Mar 7;16:84. doi: 10.25259/SNI_1100_2024. eCollection 2025.
2
Limitation of life sustaining therapy in disorders of consciousness: ethics and practice.
Brain. 2024 Jul 5;147(7):2274-2288. doi: 10.1093/brain/awae060.
3
Nursing and PharmD Undergraduate Students' Attitude Toward the "Do Not Resuscitate" Order for Children with Terminally Ill Diseases.
J Multidiscip Healthc. 2021 Feb 24;14:425-434. doi: 10.2147/JMDH.S298384. eCollection 2021.
4
Withdrawal of treatment in a pediatric intensive care unit at a Children's Hospital in China: a 10-year retrospective study.
BMC Med Ethics. 2020 Aug 12;21(1):71. doi: 10.1186/s12910-020-00517-y.
5
Time-Limited Trials in the Intensive Care Unit to Promote Goal-Concordant Patient Care.
Clin Pulm Med. 2019 Sep;26(5):141-145. doi: 10.1097/cpm.0000000000000323.
6
Nurses' Experiences and Factors Related to Their Attitudes Regarding Discussions with Patients and Family Members about Do-Not-Resuscitate Decisions and Life-Sustaining Treatment Withdrawal: A Hospital-Based Cross-Sectional Study.
Int J Environ Res Public Health. 2020 Jan 15;17(2):0. doi: 10.3390/ijerph17020557.
7
Conflict escalation in paediatric services: findings from a qualitative study.
Arch Dis Child. 2015 Aug;100(8):769-73. doi: 10.1136/archdischild-2014-307780. Epub 2015 May 4.
8
The possible impact of the German DRGs reimbursement system on end-of-life decision making in a surgical intensive care unit.
Wien Klin Wochenschr. 2015 Feb;127(3-4):109-15. doi: 10.1007/s00508-014-0638-x. Epub 2015 Jan 27.
9
Discussion of treatment trials in intensive care.
J Crit Care. 2013 Oct;28(5):862-9. doi: 10.1016/j.jcrc.2013.04.015. Epub 2013 Jun 13.
10
Climate and cultural aspects in intensive care units.
Crit Care. 2011;15(6):312. doi: 10.1186/cc10361. Epub 2011 Nov 16.
本文引用的文献
1
Concept of operations for triage of mechanical ventilation in an epidemic.
Acad Emerg Med. 2006 Feb;13(2):223-9. doi: 10.1197/j.aem.2005.07.037. Epub 2006 Jan 6.
2
Missed opportunities during family conferences about end-of-life care in the intensive care unit.
Am J Respir Crit Care Med. 2005 Apr 15;171(8):844-9. doi: 10.1164/rccm.200409-1267OC. Epub 2005 Jan 7.
3
How physicians face ethical difficulties: a qualitative analysis.
J Med Ethics. 2005 Jan;31(1):7-14. doi: 10.1136/jme.2003.005835.
4
A voice for the dying.
Clin Nurs Res. 2004 Nov;13(4):326-42. doi: 10.1177/1054773804267725.
5
Challenges in end-of-life care in the ICU: statement of the 5th International Consensus Conference in Critical Care: Brussels, Belgium, April 2003: executive summary.
Crit Care Med. 2004 Aug;32(8):1781-4. doi: 10.1097/01.ccm.0000126895.66850.14.
6
Family satisfaction with family conferences about end-of-life care in the intensive care unit: increased proportion of family speech is associated with increased satisfaction.
Crit Care Med. 2004 Jul;32(7):1484-8. doi: 10.1097/01.ccm.0000127262.16690.65.
7
Intensive care decision making in the seriously ill and elderly.
Crit Care Med. 2004 Mar;32(3):649-54. doi: 10.1097/01.ccm.0000115636.29294.2f.
8
Results of a clinical trial on care improvement for the critically ill.
Crit Care Med. 2003 Aug;31(8):2107-17. doi: 10.1097/01.CCM.0000069732.65524.72.
9
Effect of ethics consultations on nonbeneficial life-sustaining treatments in the intensive care setting: a randomized controlled trial.
JAMA. 2003 Sep 3;290(9):1166-72. doi: 10.1001/jama.290.9.1166.
10
Resolution of futility by due process: early experience with the Texas Advance Directives Act.
Ann Intern Med. 2003 May 6;138(9):743-6. doi: 10.7326/0003-4819-138-9-200305060-00011.
Zotero 插件