Szawarski Piotr
Consultant in Intensive Care Medicine and Anaesthesia, Wexham Park Hospital, Frimley Health NHS Foundation Trust, Wexham, UK.
J Intensive Care Soc. 2015 May;16(2):142-146. doi: 10.1177/1751143715569020. Epub 2015 Feb 4.
The prevalence of inappropriate care, defined as actions contrary to personal and professional beliefs, is high. This is a reflection of the reluctance of the society at large to acknowledge the biological certainty that is death. The case of Mrs Janet Tracey illustrates importance of good communication at the end of life, and the difficulties associated with making of DNACPR decisions. The case brings together two bioethical perspectives on the relationship between the patient and the physician namely the rights based approach, as emphasised by the Article 8 of the European Convention on Human Rights and the bioethical principles approach ephasising autonomy. In doing so it creates a medico-legal landmark for all those involved in management of the end of life.
不适当护理(定义为违背个人和职业信仰的行为)的发生率很高。这反映出整个社会普遍不愿承认死亡这一生物学上的必然事实。珍妮特·特雷西夫人的案例说明了临终时良好沟通的重要性,以及做出“不要进行心肺复苏”(DNACPR)决定所面临的困难。该案例汇集了关于患者与医生关系的两种生物伦理观点,即基于权利的方法(正如《欧洲人权公约》第八条所强调的)和强调自主性的生物伦理原则方法。这样一来,它为所有参与临终管理的人创造了一个医学法律里程碑。