Center for Medical Ethics & Health Policy, Baylor College of Medicine & The Methodist Hospital System, Houston, TX 77030, USA.
Aging Dis. 2013 Jan 18;4(2):100-12. Print 2013 Apr.
This article reviews some of the complex ethical issues that accompany the diffusion of ventricular assist devices (VADs) for heart failure patients, with a particular emphasis on issues unique to older adults. In doing so, the ethical issues are centered on three decision points: (a) patient selection; (b) informed consent (i.e., initiation of the device); and (c) end of life (i.e., deactivation of the device.) It is contended that, with the technological improvements in heart failure treatments and new indications, the decision making process for VAD placement and deactivation has become more clinically and ethically challenging, particularly for older adults. Areas for potential future research are identified.
本文回顾了心力衰竭患者使用心室辅助装置（VAD）所带来的一些复杂伦理问题，特别强调了老年人特有的问题。在这样做的过程中，伦理问题集中在三个决策点上：（a）患者选择；（b）知情同意（即，开始使用设备）；和（c）生命末期（即，停用设备）。有人认为，随着心力衰竭治疗技术的改进和新的适应症的出现，VAD 放置和停用的决策过程在临床上和伦理上都变得更加具有挑战性，特别是对老年人而言。确定了未来潜在的研究领域。
