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[医生在家中实施安乐死和协助自杀。2. 患者的痛苦]

[Euthanasia and assisted suicide by physicians in the home situation. 2. Suffering of the patients].

作者信息

van der Wal G, van Eijk J T, Leenen H J, Spreeuwenberg C

机构信息

Geneeskundige Inspectie van de Volksgezondheid voor Noord-Holland, Haarlem.

出版信息

Ned Tijdschr Geneeskd. 1991 Aug 31;135(35):1599-603.

PMID:1922491
Abstract

In order to assess the suffering of patients who died at home and with whom family doctors participated in euthanasia or assisted suicide, an exploratory, descriptive, retrospective study was carried out regarding primarily the period 1986-1989. Data were collected via anonymous written inquiry among an at random sample of family doctors in North Holland (n = 521), and family doctors in the rest of the Netherlands (n = 521). With reference to the last case of euthanasia or assisted suicide they had encountered questions were included about physical and emotional suffering, signs and symptoms and life expectation. Correlations and differences were analysed by means of the chi2-test. The response to the inquiry was 67% (non-responders did not otherwise differ from responders): 228 (North Holland), 160 (rest of the Netherlands) cases could be analysed. Most patients suffered physically as well as emotionally. The most frequently mentioned aspect was 'general weakness or tiredness'. Also 'dependence or being in need of help', loss of dignity, humiliation' and 'pain' were often present to a (very) large extent. At the time the procedure was carried out the life expectation in almost two-thirds of the cases was less than 2 weeks; in 10% of the cases it was more than 3 months. For several reasons, this investigation reduces the possibilities of extrapolation. Further investigation is necessary to determine whether this picture of suffering is specific of this category of patients.

摘要

为了评估在家中死亡且家庭医生参与了安乐死或协助自杀的患者的痛苦状况,我们主要针对1986 - 1989年期间开展了一项探索性、描述性的回顾性研究。通过对北荷兰省(n = 521)和荷兰其他地区(n = 521)的家庭医生进行随机抽样,以匿名书面询问的方式收集数据。针对他们遇到的最后一例安乐死或协助自杀案例,询问内容包括身体和情感上的痛苦、体征和症状以及预期寿命。采用卡方检验分析相关性和差异。调查的回复率为67%(未回复者在其他方面与回复者无差异):可分析228例(北荷兰省)和160例(荷兰其他地区)案例。大多数患者在身体和情感上都遭受痛苦。最常提到的方面是“全身虚弱或疲倦”。“依赖他人或需要帮助”、尊严丧失、羞辱感和“疼痛”在很大程度上也经常出现。在实施该程序时,近三分之二案例的预期寿命不到2周;10%的案例预期寿命超过3个月。由于多种原因,本次调查降低了外推的可能性。有必要进行进一步调查,以确定这种痛苦状况是否为此类患者所特有。

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