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缓和镇静与医疗辅助死亡:明显不同还是仅仅是语义上的差异?

Palliative sedation and medical assistance in dying: Distinctly different or simply semantics?

机构信息

Palliative and End-of-Life Care Services, Calgary, AB, Canada.

Tom Baker Cancer Centre, Calgary, AB, Canada.

出版信息

Nurs Inq. 2020 Jan;27(1):e12321. doi: 10.1111/nin.12321. Epub 2019 Nov 22.

Abstract

Medical assistance in dying (MAiD) and palliative sedation (PS) are both legal options in Canada that may be considered by patients experiencing intolerable and unmanageable suffering. A contentious, lively debate has been ongoing in the literature regarding the similarities and differences between MAiD and PS. The aim of this paper is to explore the propositions that MAiD and PS are essentially similar and conversely that MAiD and PS are distinctly different. The relevance of such a debate is apparent for clinicians and patients alike. Understanding the complex and multi-faceted nuances between PS and MAiD allows patients and caregivers to make more informed decisions pertaining to end-of-life care. It is hoped that this paper will also serve to foster further debate and consideration of the issues associated with PS and MAiD with a view to improve patient care and the quality of both living and dying in Canada.

摘要

医疗辅助死亡(MAiD)和缓和性镇静(PS)在加拿大都是合法的选择,那些正在经历无法忍受和无法控制的痛苦的患者可能会考虑这两种选择。文献中一直在进行关于 MAiD 和 PS 之间相似性和差异性的激烈、活跃的辩论。本文的目的是探讨 MAiD 和 PS 在本质上是相似的这一观点,以及相反的 MAiD 和 PS 是截然不同的这一观点。对于临床医生和患者来说,这样的辩论都具有明显的现实意义。理解 PS 和 MAiD 之间复杂的、多方面的细微差别,使患者和护理人员能够就临终关怀做出更明智的决定。希望本文也能促进对 PS 和 MAiD 相关问题的进一步辩论和考虑,以期改善加拿大的患者护理和生活质量。

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Canadian and Dutch doctors' roles in assistance in dying.加拿大和荷兰医生在协助死亡中的角色。
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本文引用的文献

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Reflections on palliative sedation.关于姑息性镇静的思考
Palliat Care. 2019 Jan 27;12:1178224218823511. doi: 10.1177/1178224218823511. eCollection 2019.
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Medical Assistance in Dying at a paediatric hospital.儿科医院的安乐死医疗协助。
J Med Ethics. 2019 Jan;45(1):60-67. doi: 10.1136/medethics-2018-104896. Epub 2018 Sep 21.

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