Schlairet Maura C, Cohen Richard W
Valdosta State University, Valdosta, GA 31698, USA.
HEC Forum. 2013 Jun;25(2):161-71. doi: 10.1007/s10730-012-9181-1.
Conversations with patients and families about the allow-natural-death (AND) order, along with the standard do-not-resuscitate (DNR) order during end-of-life (EOL) decision-making, may create engagement and understanding while promoting care that can be defended using enduring notions of autonomy, beneficence, and professional duty. Ethical, legal, and pragmatic issues surrounding EOL care decision-making seem to suggest discussion of AND orders as one strategy clinicians could consider at the individual practice level and at institutional levels. A discussion of AND orders, along with traditional DNR orders is presented. This is followed by argument and counter-argument focused on ethical, legal, and practical issues germane to EOL care decision-making associated with use of AND orders.
在临终（EOL）决策过程中，与患者及其家属就允许自然死亡（AND）医嘱以及标准的不要复苏（DNR）医嘱进行沟通，可能会促进参与和理解，同时推动基于自主性、行善原则和职业责任等持久观念的可辩护的护理。围绕临终护理决策的伦理、法律和实际问题似乎表明，讨论AND医嘱是临床医生在个人实践层面和机构层面可以考虑的一种策略。本文介绍了AND医嘱以及传统DNR医嘱的讨论情况。随后是针对与使用AND医嘱相关的临终护理决策所涉及的伦理、法律和实际问题的正反两方面论证。
