“请让妈妈再多活一天”——濒死患者与其替代决策者的冲突指令
"Please Keep Mom Alive One More Day"-Clashing Directives of a Dying Patient and Her Surrogate.
作者信息
Latcha Sheron, Lineberry Camille, Lendvai Nikoletta, Tran Christine A, Matsoukas Konstantina, Scharf Amy E, Voigt Louis P
机构信息
Ethics Committee, Memorial Sloan Kettering Cancer Center, New York, New York, USA; Department of Medicine, Renal Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
Ethics Committee, Memorial Sloan Kettering Cancer Center, New York, New York, USA; Department of Nursing, Memorial Sloan Kettering Cancer Center, New York, New York, USA; Department of Anesthesiology, Pain, and Critical Care Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
出版信息
J Pain Symptom Manage. 2020 May;59(5):1147-1152. doi: 10.1016/j.jpainsymman.2020.01.014. Epub 2020 Jan 31.
All medical care providers are legally and ethically bound to respect their patients' wishes. However, as patients lose decision-making capacity and approach end of life, their families or surrogates, who are confronted with grief, fear, self-doubt, and/or uncertainty, may ask physicians to provide treatment that contradicts the patients' previously stated wishes. Our work discusses the legal and ethical issues surrounding such requests and provides guidance for clinicians to ethically and compassionately respond-without compromising their professional and moral obligations to their patients.
所有医疗服务提供者在法律和道德上都有义务尊重患者的意愿。然而，当患者失去决策能力并接近生命末期时，他们面临悲伤、恐惧、自我怀疑和/或不确定性的家人或代理人，可能会要求医生提供与患者先前表达的意愿相矛盾的治疗。我们的工作讨论了围绕此类请求的法律和道德问题，并为临床医生提供指导，以便他们在不损害对患者的专业和道德义务的情况下，做出符合伦理且富有同情心的回应。
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