Szaflarski N L
AACN Clin Issues Crit Care Nurs. 1990 May;1(1):215-24. doi: 10.4037/15597768-1990-1022.
The issue of whether or not the life-sustaining treatments (LST) of critical care is warranted for patients with the acquired immunodeficiency syndrome (AIDS) experiencing acute respiratory failure has been raised. Factors that have contributed to this issue include the AIDS epidemic, the high costs of critical care, limited intensive care resources, high mortality, prolonged suffering, and the effects on caregivers in delivering futile care. This article examines this issue from the ethicality of the decision-making process regarding LST in context with medical futility, patient autonomy, and discussion among patients and caregivers. The allocation of critical care resources for AIDS patients with respiratory failure is analyzed from the viewpoint of distributive justice. The nursing implications of providing critical care to these patients and their families are discussed as well as needed areas of research.
对于患有获得性免疫缺陷综合征（艾滋病）且出现急性呼吸衰竭的患者，是否有必要进行重症监护的维持生命治疗（LST）这一问题已经被提了出来。导致这个问题的因素包括艾滋病的流行、重症监护的高昂成本、有限的重症监护资源、高死亡率、长期的痛苦以及对护理人员提供无效护理的影响。本文从关于维持生命治疗决策过程的伦理角度，结合医疗无效性、患者自主权以及患者与护理人员之间的讨论，审视了这个问题。从分配正义的角度分析了为患有呼吸衰竭的艾滋病患者分配重症监护资源的情况。还讨论了为这些患者及其家属提供重症监护的护理意义以及所需的研究领域。
