Department of Internal Medicine, Section of Pulmonary and Critical Care Medicine, Yale University School of Medicine, New Haven, CT 06520-8057, USA.
Semin Respir Crit Care Med. 2012 Aug;33(4):382-92. doi: 10.1055/s-0032-1322402. Epub 2012 Aug 8.
Medical care offered to the critically ill often occurs by default, unfolding automatically unless concerted effort is made to do otherwise. In their scope, defaults include traditional approaches to treatment and decision making, as well as policies deliberately set to promote specific health outcomes. Defaults are ethically sound to the extent that they foster patient well-being and autonomy. Unfortunately in practice, some defaults lead to ineffective, unwanted, and expensive care. This article reviews the ethical and economic impact of defaults, paying special attention to their influence on the practice of cardiopulmonary resuscitation and admission to the intensive care unit.
对病危患者的医疗护理通常是默认提供的，除非刻意采取其他行动，否则会自动展开。在其范围内，默认项包括传统的治疗和决策方法，以及为促进特定健康结果而制定的政策。只要默认项能促进患者的健康和自主权，它们在道德上就是合理的。不幸的是，在实践中，一些默认项导致了无效、不必要和昂贵的护理。本文回顾了默认项的伦理和经济影响，特别关注它们对心肺复苏术和入住重症监护病房实践的影响。
