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认知障碍患者肿瘤治疗的社会心理和法律问题

Psychosocial and legal aspects of oncological treatment in patients with cognitive impairment.

作者信息

Kuśnierkiewicz Maria, Kędziora Justyna, Jaroszyk-Pawlukiewicz Joanna, Nowak-Jaroszyk Monika

机构信息

Greater Poland Cancer Centre, Clinical Psychology Unit, Poland.

Adam Mickiewicz University, Faculty of Historical Studies, Institute of History, Department of Economic History, Poland.

出版信息

Rep Pract Oncol Radiother. 2013 Dec 30;19(3):157-64. doi: 10.1016/j.rpor.2013.09.012. eCollection 2014 May.

Abstract

With society getting older and affected by many diseases, more and more people suffer from severe cognitive disorders. As practice shows, the legal situations of such people is often problematic. This is due to a number of factors, such as short time since the deterioration of patient's condition, initial symptoms ignored, social prejudice towards the idea of incapacitation or taking decisions for a patient, complicated procedures and, sometimes, insufficient knowledge of legal regulations. Cognitive disorders also occur in patients treated for cancer. To be effective, oncological treatment needs to be started as early as possible. This, however, does not meet the criteria of sudden threat to life. The present article relates to both the psychosocial and legal aspects of care of people suffering from intense disorders of memory, attention, problem solving, executive functions, and other. Surely, physicians know how to handle patients with the above dysfunctions. However, legal procedures aimed to protect patients' rights are often unclear and time consuming. In practice, this often amounts to a dilemma whether to treat or follow the applicable law. Certainly, solutions in this regard should be clearer and better adapted to the needs arising from specific treatment needs of particular groups of patients.

摘要

随着社会老龄化以及受多种疾病影响,越来越多的人患有严重的认知障碍。实践表明,这类人的法律状况往往存在问题。这是由多种因素造成的,比如患者病情恶化后的时间较短、初始症状被忽视、社会对无行为能力或为患者做决定这一观念存在偏见、程序复杂,以及有时对法律法规的了解不足。认知障碍也会出现在癌症患者身上。为了取得疗效,肿瘤治疗需要尽早开始。然而,这并不符合对生命构成突然威胁的标准。本文涉及对患有严重记忆、注意力、解决问题、执行功能等障碍的人群进行护理的心理社会和法律方面。当然,医生知道如何处理有上述功能障碍的患者。然而,旨在保护患者权利的法律程序往往不明确且耗时。在实践中,这常常导致在治疗还是遵循适用法律之间陷入两难境地。当然,这方面的解决方案应该更清晰,并且更好地适应特定患者群体特殊治疗需求所产生的需要。

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