Chessa Frank, Moreno Fernando
Maine Medical Center, Tufts University School of Medicine, 22 Bramhall Street, Portland, ME 04102, USA.
Department of Family Medicine and the Division of Palliative Medicine, Maine Medical Center, Hospice of Southern Maine, Tufts University School of Medicine, 180 US Route One, Scarborough, ME 04074, USA.
Prim Care. 2019 Sep;46(3):387-398. doi: 10.1016/j.pop.2019.05.005. Epub 2019 Jun 10.
In caring for dying patients, family medicine practitioners intentionally adopt care plans that affect the manner and timing of death. These decisions are morally weighty. This article provides guidance regarding the ethical and legal appropriateness of practitioner decisions near the end of life. Topics include surrogate decision making, advance care planning, medical nutrition and hydration, double effect, futile care, physician-assisted death, voluntarily stopping eating and drinking, palliative sedation to unconsciousness, and cultural humility.
在照料临终患者时，家庭医生会有意采用影响死亡方式和时间的护理计划。这些决策具有重大的道德意义。本文就医生在生命末期所做决策的伦理和法律适宜性提供指导。主题包括替代决策、预先护理计划、医疗营养与补液、双重效应、无效治疗、医生协助死亡、自愿停止进食和饮水、姑息性镇静至无意识状态以及文化谦逊。
