Wainwright Paul, Gallagher Ann
Kingston University, Kingston upon Thames, Surrey.
Nurs Stand. 2007;21(33):46-50. doi: 10.7748/ns2007.04.21.33.46.c4548.
Decisions about withdrawing and withholding treatment are common in health care. During almost every encounter between health professionals and patients a decision needs to be made about treatment options. In most cases these choices do not pose any difficulty, for example, starting antibiotics when a patient has an infection. However, decisions not to treat, or to stop treating, raise fundamental questions about the nature and purpose of nursing and the ethics of end-of-life care. This article argues that nurses need to be proactive in deciding what is nursing care and what is treatment. An ethical distinction is drawn between acts and omissions. How this distinction relates to withdrawing and withholding treatment will be considered. Further ethical issues discussed relate to judgements about the futility of treatment, patient autonomy and nurses' duty of care to patients at the end of life.
在医疗保健中，关于停止和放弃治疗的决策很常见。在医护人员与患者几乎每次接触时，都需要就治疗方案做出决定。在大多数情况下，这些选择不会造成任何困难，例如，患者感染时开始使用抗生素。然而，不进行治疗或停止治疗的决定引发了关于护理的性质和目的以及临终护理伦理的基本问题。本文认为，护士需要积极主动地决定什么是护理、什么是治疗。在作为与不作为之间做出了伦理区分。将考虑这种区分与停止和放弃治疗的关系。所讨论的其他伦理问题涉及对治疗无效性的判断、患者自主权以及护士在患者临终时的护理责任。
