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[重症监护患者姑息治疗中的伦理挑战]

[Ethical challenge in palliative support of intensive care patients].

作者信息

Salomon Fred

出版信息

Anasthesiol Intensivmed Notfallmed Schmerzther. 2015 Jan;50(1):48-54. doi: 10.1055/s-0040-100358. Epub 2015 Feb 2.

Abstract

Intensive care medicine and palliative care medicine were considered for a long time to be contrasting concepts in therapy. While intensive care medicine is directed towards prolonging life and tries to stabilize disordered body functions, palliative care medicine is focused upon the relief of disturbances to help patients in the face of death. Today both views have become congruent. Palliative aspects are equally important in curative therapy. In the course of illness or in respect of the patient's will, the aim of therapy may change from curative to palliative. Two examples are presented to illustrate the ethical challenges in this process. They follow from the medical indication, attention to the patient's will, different opinions in the team, truth at the bedside and from what must be done in the process of withdrawing therapy.

摘要

长期以来,重症医学和姑息治疗医学在治疗方面被视为相互对立的概念。重症医学旨在延长生命并试图稳定紊乱的身体功能,而姑息治疗医学则专注于缓解不适,以帮助患者面对死亡。如今,这两种观点已趋于一致。姑息治疗方面在治愈性治疗中同样重要。在疾病过程中或根据患者的意愿,治疗目标可能从治愈性转变为姑息性。本文给出两个例子来说明这一过程中的伦理挑战。这些挑战源于医学指征、对患者意愿的关注、团队中的不同意见、床边的真相以及撤掉治疗过程中必须做的事情。

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