Blumenthal-Barby J S, Loftis Laura, Cummings Christy L, Meadow William, Lemmon Monica, Ubel Peter A, McCullough Laurence, Rao Emily, Lantos John D
Baylor College of Medicine, Houston, Texas.
Boston Children's Hospital, Harvard School of Medicine, Boston, Massachusetts.
Pediatrics. 2016 Dec;138(6). doi: 10.1542/peds.2016-2585. Epub 2016 Nov 9.
An infant has a massive intracranial hemorrhage. She is neurologically devastated and ventilator-dependent. The prognosis for pulmonary or neurologic recovery is bleak. The physicians and parents face a choice: withdraw the ventilator and allow her to die or perform a tracheotomy? The parents cling to hope for recovery. The physician must decide how blunt to be in communicating his own opinions and recommendations. Should the physician try to give just the facts? Or should he also make a recommendation based on his own values? In this article, experts in neonatology, decision-making, and bioethics discuss this situation and the choice that the physician faces.
一名婴儿出现大量颅内出血。她神经系统严重受损，依赖呼吸机维持生命。肺部或神经功能恢复的预后很渺茫。医生和家长面临一个抉择：撤掉呼吸机任其死亡，还是进行气管切开术？家长仍抱有康复的希望。医生必须决定在表达自己的意见和建议时要多直白。医生应该只陈述事实吗？还是也应基于自己的价值观提出建议？在本文中，新生儿学、决策制定和生物伦理学领域的专家探讨了这种情况以及医生所面临的抉择。
