Omery A, Caswell D
Crit Care Nurs Clin North Am. 1989 Mar;1(1):165-73.
Brain resuscitation is the newest in a long line of treatment protocols that is designed to aid us in sustaining not just life, but quality life in the critical care setting. Like other, previously established protocols, it is not value free. Its implementation brings ethical considerations that must be addressed. If the issues are not addressed, there is the real danger that the resulting moral dilemmas will overwhelm the nurse. In brain resuscitation, there are at least three ethical issues that must be recognized. These are the role of resuscitation in the life process, allocation of scarce resources, and participation in research. To address these issues, nurses will have to be aware of the ethical principle and/or perspectives involved. For some of these issues, the solutions will have to come from nursing's national organizations, such as the American Association of Critical Care Nurses. Other solutions presented will require the nurse to come to an individual decision regarding the ethics of brain resuscitation. The journey to the conclusion of this discussion will end with disappointment for those who sought an algorhythm or decision tree with which to make definitive decisions in regard to ethical decisions about brain resuscitation. To have assumed that such an absolute discussion in regard to the ethical perspectives related to brain resuscitation is possible or even desirable would have been to deny the moral/ethical responsibilities of the nurse who practices in a critical care setting. While these ethical responsibilities can be overwhelmingly burdensome, they can also be opportunities. They can be positive opportunities for our health care colleagues, our patients, and ourselves.
脑复苏是一系列治疗方案中的最新方案，这些方案旨在帮助我们不仅维持生命，而且在重症监护环境中维持高质量的生活。与其他先前制定的方案一样，它并非没有价值取向。其实施带来了必须解决的伦理考量。如果这些问题得不到解决，就存在真正的危险，即由此产生的道德困境将压垮护士。在脑复苏中，至少有三个伦理问题必须得到认识。这些问题是复苏在生命过程中的作用、稀缺资源的分配以及参与研究。为了解决这些问题，护士必须了解其中涉及的伦理原则和/或观点。对于其中一些问题，解决方案必须来自护理领域的全国性组织，如美国重症护理护士协会。提出的其他解决方案将要求护士就脑复苏的伦理问题做出个人决定。对于那些寻求一种算法或决策树来就脑复苏的伦理决策做出明确决定的人来说，这场讨论的结论之旅将以失望告终。假设对于与脑复苏相关的伦理观点进行如此绝对的讨论是可能的甚至是可取的，那就等于否认了在重症监护环境中执业的护士的道德/伦理责任。虽然这些伦理责任可能极其沉重，但它们也可能是机会。它们可以为我们的医护同事、我们的患者以及我们自己带来积极的机会。
