Wong Nora W
The founder and executive director of the NORSE Institute.
AMA J Ethics. 2018 Aug 1;20(8):E782-786. doi: 10.1001/amajethics.2018.782.
This article addresses whether physicians' close ties to their patients might play an unexamined role in their reluctance to initiate palliative care. In cases characterized by uncertainty, physicians' emotional investment in their patients and patients' families might unduly promote decisions to continue aggressive treatment rather than transition to comfort care. Continued evaluation and communication of patient status, including scheduled objective consultations, can align compassionate actions with patients' best interests. This argument and analysis are based on a case of new onset refractory status epilepticus (NORSE).
本文探讨了医生与患者的密切关系是否可能在他们不愿启动姑息治疗方面起到未被审视的作用。在存在不确定性的情况下,医生对患者及其家属的情感投入可能会过度促使他们做出继续积极治疗而非转向舒适护理的决定。持续评估和沟通患者状况,包括安排客观会诊,可以使富有同情心的行动符合患者的最大利益。这一论点和分析基于一例新发难治性癫痫持续状态(NORSE)的病例。