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无行为能力患者的治疗决策:患者偏好预测器的开发与使用是否可行?

Treatment decision making for incapacitated patients: is development and use of a patient preference predictor feasible?

作者信息

Rid Annette, Wendler David

机构信息

*Department of Social Science, Health & Medicine, King's College London, Strand, London WC2R 2LS, UK.

出版信息

J Med Philos. 2014 Apr;39(2):130-52. doi: 10.1093/jmp/jhu006. Epub 2014 Feb 20.

Abstract

It has recently been proposed to incorporate the use of a "Patient Preference Predictor" (PPP) into the process of making treatment decisions for incapacitated patients. A PPP would predict which treatment option a given incapacitated patient would most likely prefer, based on the individual's characteristics and information on what treatment preferences are correlated with these characteristics. Including a PPP in the shared decision-making process between clinicians and surrogates has the potential to better realize important ethical goals for making treatment decisions for incapacitated patients. However, developing and implementing a PPP poses significant practical challenges. The present paper discusses these practical challenges and considers ways to address them.

摘要

最近有人提议将“患者偏好预测器”(PPP)的使用纳入为无行为能力患者做出治疗决策的过程中。PPP将根据个体特征以及与这些特征相关的治疗偏好信息,预测特定无行为能力患者最可能偏好的治疗方案。在临床医生和替代决策者之间的共同决策过程中纳入PPP,有可能更好地实现为无行为能力患者做出治疗决策的重要伦理目标。然而,开发和实施PPP面临重大的实际挑战。本文讨论了这些实际挑战并思考了应对方法。

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