Lyu Chunmei, Zhang Li
The First People's Hospital of Foshan, Affiliated with Sun Yat-Sen University, China.
Department of Nursing, The First People's Hospital of Foshan, Affiliated with Sun Yat-Sen University, China.
Int J Nurs Sci. 2018 Jun 26;5(3):310-314. doi: 10.1016/j.ijnss.2018.06.004. eCollection 2018 Jul 10.
Withdrawal of treatment is a common practice in critical care settings, perticularly when treatment is considered futile. The case study demonstrates an ethical dilemma, in which Danny is unlikely to make a functional recovery because of multiple organ dysfunction syndromes. Under such a circumstance, withdrawal of treatment will inevitably be considered, although his family refused to do so. Consequently, acritical question must be answered: Who should make the decision?
Danny decided to withdraw the use of life-support, whilst his wife and adult children refused to do so. The ethical dilemma is illustrated by the following question: Who decides the withdrawal of treatment in a critical care setting?
To provide an opotional solution to this case and make the best moral decision, the current study will critically discuss this issue in conjunction with ethical principles, philosophical theories and the values statement of the European and Chinese nurses' codes of ethics. Additionally, the associated literature relative to this case are analysed before the decision-making.
ETHICAL DECISION-MAKING: The best ethical decision is Danny can decide whether to withhold or withdraw life-sustaining treatment. If his family is involved in the discussion, the medical staff should balance the ethical principles when they make the decision and allocate reasonable resources for patients.
In Danny's case, health professionals opted to respect his decision to withdraw treatment. The medical staff maintained an effective communication with the family involved, and provided the appropriate intervention to collaborate with other health care professionals to perfect further care.
在重症监护环境中，停止治疗是一种常见做法，尤其是在治疗被认为无意义时。该案例研究展示了一个伦理困境，即丹尼由于多器官功能障碍综合征不太可能实现功能性康复。在这种情况下，尽管他的家人拒绝，但停止治疗将不可避免地被考虑。因此，必须回答一个关键问题：应该由谁来做这个决定？
丹尼决定停止使用生命维持设备，而他的妻子和成年子女拒绝这样做。以下问题体现了这一伦理困境：在重症监护环境中谁来决定停止治疗？
为了给这个案例提供一个可选的解决方案并做出最佳的道德决策，本研究将结合伦理原则、哲学理论以及欧洲和中国护士伦理准则的价值观声明来批判性地讨论这个问题。此外，在决策前分析与此案例相关的文献。
最佳的伦理决策是丹尼可以决定是否停止或撤销维持生命的治疗。如果他的家人参与讨论，医护人员在做决定时应权衡伦理原则，并为患者分配合理的资源。
在丹尼的案例中，医疗专业人员选择尊重他停止治疗的决定。医护人员与相关家人保持了有效的沟通，并提供了适当的干预措施，以与其他医疗保健专业人员合作完善后续护理。
