Everett Bethan J, Albersheim Susan G
Faculty of Medicine, Department of Physical Therapy, University of British Columbia.
J Clin Ethics. 2011 Spring;22(1):54-60.
Offering intensive care to neonates who have conditions that carry extremely poor prognoses is a source of great contention amongst neonatologists. The concept of best interests is commonly used as a rationale for refusing such care, despite the fact that parents of these infants often have a different view of what best interests means. This article takes up the question of what best interests should incorporate for infants with lethal conditions not curable with intensive care, and how and who should decide which treatment options should be implemented. Based on our recommendation that parents be apprised of the basis upon which physicians are evaluating treatment options, we offer a framework that allows all relevant parties to approach the issue of what is appropriate treatment from a similar place. We maintain that this approach will increase transparency, dialogue, understanding, and trust, which, in turn, may result in greater consensus.
为患有预后极差病症的新生儿提供重症监护，这在新生儿科医生中引发了极大的争议。尽管这些婴儿的父母对“最大利益”的含义往往有不同看法，但“最大利益”的概念通常被用作拒绝此类治疗的理由。本文探讨了对于患有无法通过重症监护治愈的致命病症的婴儿，“最大利益”应包含哪些内容，以及如何决定并由谁来决定应实施哪些治疗方案。基于我们的建议，即应告知父母医生评估治疗方案的依据，我们提供了一个框架，使所有相关方能够从类似的角度来探讨何种治疗是恰当的这一问题。我们认为，这种方法将提高透明度、促进对话、增进理解并增强信任，进而可能达成更大程度的共识。
