Bostwick J Michael
Professor of Psychiatry, Mayo Clinic College of Medicine, Rochester, MN, USA.
Rambam Maimonides Med J. 2015 Apr 29;6(2):e0013. doi: 10.5041/RMMJ.10197. eCollection 2015 Apr.
Suicidal phenomena in the general hospital can take a variety of forms that can be parsed by taking into account whether or not the patient 1) intended to hasten death, and 2) included collaborators, including family and health care providers, in the decision to act. These two criteria can be used to distinguish entities as diverse as true suicide, non-compliance, euthanasia/physician-assisted suicide, and hospice/palliative care. Characterizing the nature of "suicide" events facilitates appropriate decision-making around management and disposition.
综合医院中的自杀现象可能呈现多种形式，可通过考虑以下两点来进行剖析：1）患者是否有意加速死亡；2）在采取行动的决策过程中是否有包括家人和医疗服务提供者在内的协助者。这两条标准可用于区分各种不同的情况，如真正的自杀、不遵医嘱、安乐死/医生协助自杀以及临终关怀/姑息治疗。明确“自杀”事件的性质有助于围绕管理和处置做出恰当的决策。
