Penn State College of Medicine, Humanities & Pediatrics, Hershey, PA 17033, USA.
Am J Bioeth. 2010 Apr;10(4):3-22. doi: 10.1080/15265161003599691.
In the face of mounting criticism against advance directives, we describe how a novel, computer-based decision aid addresses some of these important concerns. This decision aid, Making Your Wishes Known: Planning Your Medical Future, translates an individual's values and goals into a meaningful advance directive that explicitly reflects their healthcare wishes and outlines a plan for how they wish to be treated. It does this by (1) educating users about advance care planning; (2) helping individuals identify, clarify, and prioritize factors that influence their decision-making about future medical conditions; (3) explaining common end-of-life medical conditions and life-sustaining treatment; (4) helping users articulate a coherent set of wishes with regard to advance care planning-in the form of an advance directive readily interpretable by physicians; and (5) helping individuals both choose a spokesperson, and prepare to engage family, friends, and health care providers in discussions about advance care planning.
面对越来越多的针对预立医疗指示的批评,我们描述了一种新的、基于计算机的决策辅助工具如何解决其中的一些重要问题。这个决策辅助工具“让您的意愿为人所知:规划您的医疗未来”将个人的价值观和目标转化为有意义的预立医疗指示,明确反映他们的医疗意愿,并概述了他们希望如何接受治疗的计划。它通过以下方式实现这一点:(1)教育用户有关预立医疗指示的知识;(2)帮助个人识别、澄清和优先考虑影响他们对未来医疗状况决策的因素;(3)解释常见的临终医疗状况和维持生命的治疗;(4)帮助用户以医生易于理解的预立医疗指示形式表达一整套连贯的意愿;(5)帮助个人选择代理人,并准备与家人、朋友和医疗保健提供者就预立医疗指示进行讨论。