Centre for Health and Society, University of Melbourne VIC 3010, Australia.
J Med Ethics. 2011 Nov;37(11):646-9. doi: 10.1136/jme.2010.041095. Epub 2011 May 19.
Futile treatment is one ethically challenging situation commonly encountered by junior doctors. By analysing an intern's story using a role virtues framework, I propose a set of three steps for junior doctors facing this problem. I claim that junior doctors ought always to investigate the rationale underlying decisions to proceed with apparently futile treatment and discuss their concerns with their seniors, even if such discussion will be difficult. I also suggest that junior doctors facing this ethical challenge ought always to be willing to initiate and engage in ethical dialogue, and that in some situations further action (such as taking concerns outside the team or refusing to participate in treatment) may be morally appropriate.
无效治疗是初级医生经常遇到的一个具有伦理挑战性的情况。通过使用角色美德框架分析一个实习医生的故事,我为初级医生面对这个问题提出了三个步骤。我认为,初级医生应该始终调查继续进行明显无效治疗的决策背后的基本原理,并与上级讨论他们的担忧,即使这种讨论可能很困难。我还建议,面对这一伦理挑战的初级医生应该始终愿意发起并参与道德对话,并且在某些情况下,可能需要采取进一步的行动(例如将问题提交给团队外或拒绝参与治疗)。