Carter Brian S, Wocial Lucia D
Vanderbilt University School of Medicine, Nashville, TN 37232, USA.
Am J Hosp Palliat Care. 2012 Mar;29(2):146-50. doi: 10.1177/1049909111410560. Epub 2011 Jun 10.
Over the past 30 years, and increasingly over the past decade, palliative care services characteristically address the complexity of communication, decision making, and management of end-of-life issues for patients and families of all ages. Clinical ethics services have a parallel 30-plus year history in the United States-so much so that some have offered that clinical ethics has "cut its teeth" on issues attendant to the beginning and end of life. The authors propose considerations necessary in determining the appropriateness of consultation with palliative care, clinical ethics, or both, and when either may be necessary but perhaps not sufficient for patient and family management. A resolution for any encountered tension and identification of common or overlapping domains for both consultants is presented.
在过去30年里，尤其是在过去10年中，姑息治疗服务的特点是解决各年龄段患者及其家属在沟通、决策和临终问题管理方面的复杂性。临床伦理服务在美国也有30多年的历史——以至于有些人认为临床伦理在生命起点和终点相关问题上“初试锋芒”。作者提出了在确定咨询姑息治疗、临床伦理或两者是否合适时所需考虑的因素，以及何时两者可能是必要的，但对患者及其家属的管理而言或许并不充分。本文还提出了解决任何遇到的紧张关系的方法，并确定了两位咨询人员的共同或重叠领域。
