Department of Psychiatry, University of Colorado, Denver, Colorado, USA.
Int J Eat Disord. 2010 May;43(4):372-7. doi: 10.1002/eat.20701.
The concept of medical futility is accepted in general medicine, yet little attention has been paid to its application in psychiatry. We explore how medical futility and principles of palliation may contribute to the management of treatment refractory anorexia nervosa.
We review the case of a 30-year-old woman with chronic anorexia nervosa, treated unsuccessfully for several years.
Ongoing assessment, including ethical consultation, determined that further active treatment was unlikely to resolve her condition. The patient was referred for palliative care and hospice care, and ultimately died.
Although circumstances requiring its use are rare, palliative care may play a role in the treatment of long suffering, treatment refractory patients. For poor prognosis patients who are unresponsive to competent treatment, continue to decline physiologically and psychologically, and appear to face an inexorably terminal course, palliative care and hospice may be a humane alternative.
无效医疗的概念在一般医学中被接受，但在精神病学中很少关注其应用。我们探讨无效医疗和姑息治疗原则如何有助于治疗难治性神经性厌食症。
我们回顾了一位 30 岁女性慢性神经性厌食症患者的病例，她多年来治疗效果不佳。
持续评估，包括伦理咨询，确定进一步积极治疗不太可能解决她的病情。患者被转介进行姑息治疗和临终关怀，最终死亡。
尽管需要使用姑息治疗的情况很少见，但姑息治疗可能在治疗长期受苦、治疗无效的患者方面发挥作用。对于预后不良、对有能力的治疗无反应、继续在生理和心理上恶化、并似乎面临不可避免的终末期的患者，姑息治疗和临终关怀可能是一种人道的替代方案。
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