[终末期阿尔茨海默病患者生命延长治疗的 withhold 与 withdraw] 注：“withhold”和“withdraw”在这里可能有特定医学语境含义，比如“ withhold”可能指“ withhold treatment”（停止治疗），“withdraw”可能指“ withdraw treatment”（撤回治疗），但仅根据所给英文标题较难准确完整翻译这两个词，具体意思需结合完整文本内容确定。以上译文仅按要求翻译了标题字面内容。

[The withholding and withdrawing of life-prolonging treatment for end-stage Alzheimer disease patients].

作者信息

Minooka Masako

机构信息

Dept. of Biomedical Ethics, School of Health Science and Nursing, The University of Tokyo Graduate School of Medicine.

出版信息

Gan To Kagaku Ryoho. 2007 Dec;34 Suppl 2:203-4.

PMID:20443261

Abstract

Due to an increase in the number of patients suffering from Alzheimer's disease, issues relating to the withholding and withdrawing of life-prolonging treatment are in urgent need for discussion. We asked care-givers, nurses, doctors and lawyers what they think about the withholding and withdrawing of artificial hydration and nutrition and pneumonia therapy from end-stage Alzheimer disease patients. The most important factors affecting the withholding and withdrawing of life-prolonging treatment are: (1) advanced directives, (2) the family intention and (3) futility of treatment. In concerning the advanced directives in particular, both medical staffs and lawyers should recognize its importance. Further conversation will help medical, ethical, and legal viewpoints reach a consensus. The prevalence of advanced directives and incorporating the hospice concept in the care for end-stage Alzheimer disease patients are both necessary.

摘要

由于阿尔茨海默病患者数量的增加，与延长生命治疗的 withhold（ withhold 在此语境中可理解为“ withhold（不给予）” ）和撤除相关的问题亟待讨论。我们询问了护理人员、护士、医生和律师，他们对于终末期阿尔茨海默病患者不给予和撤除人工补液及营养以及肺炎治疗有何看法。影响延长生命治疗的 withhold 和撤除的最重要因素是：（1）预先指示，（2）家庭意愿，以及（3）治疗的无效性。特别是关于预先指示，医务人员和律师都应认识到其重要性。进一步的对话将有助于医学、伦理和法律观点达成共识。预先指示的普及以及将临终关怀概念纳入终末期阿尔茨海默病患者的护理中都是必要的。（注：这里 withhold 翻译为“不给予”更符合语境，因为是在讨论对患者不给予某些治疗措施等情况。）