a New Mexico Veterans Affairs Health Care System and University of New Mexico School of Medicine.
Am J Bioeth. 2015;15(7):34-43. doi: 10.1080/15265161.2015.1039720.
Comparatively little scholarly attention has been given to the question of futility in chronic psychiatric disorders, with the exception of a small body of work on so-called end-stage anorexia nervosa (AN). A review of this literature provides the background for a critical examination of whether the concept of futility has any clinically meaningful, ethically justifiable, and legally defensible application to AN. In this article, the arguments for and against futility judgments in AN are analyzed with special emphasis on determinations of capacity in this serious mental illness. Parallels between the futility disputes in medical and psychiatric disorders, where applicable, will be drawn to further illuminate whether or not the concept that continued psychiatric treatment for AN is ever truly futile.
相较于慢性精神疾病无效性的问题,学术研究关注较少,除了一小部分关于所谓晚期神经性厌食症(AN)的研究。本文回顾了这一文献,批判性地考察了无效性概念是否在临床上具有有意义、伦理上合理和法律上可辩护的应用于 AN。在本文中,将分析 AN 中无效性判断的正反论据,并特别强调在这种严重精神疾病中能力的确定。在适用的情况下,将比较医疗和精神科疾病中的无效性争议,以进一步阐明 AN 的持续精神科治疗是否真的无效。