Stahl Devan, Tomlinson Tom
Department of Religion, Baylor University, Waco, TX, USA.
Michigan State University, East Lansing, MI, USA.
Linacre Q. 2019 Nov;86(4):394-403. doi: 10.1177/0024363919874957. Epub 2019 Sep 23.
When a patient is declared dead using neurological criteria, intense emotional and ethical challenges can follow. In our experience as clinical ethicists, consults surrounding the declaration of "brain death" can be some of the most difficult. In what follows, we describe some best practices related to death by neurological criteria (DNC). We begin with important policies hospitals need to have in place to ensure that death is properly understood by all members of the clinical team and place some limits on the authority of families to demand continued "treatment" for deceased patients. Next, we explain how best to prepare families for the diagnosis. We then discuss how to talk to families when breaking the news concerning DNC. Finally, we describe how to approach a family that is resisting the determination of death.
This article advises clinicians on how to talk to families about brain death.
当根据神经学标准宣布患者死亡时，随之而来的可能是强烈的情感和伦理挑战。根据我们作为临床伦理学家的经验，围绕“脑死亡”宣布的咨询可能是最具挑战性的一些情况。在接下来的内容中，我们将描述一些与神经学标准判定死亡（DNC）相关的最佳实践。我们首先阐述医院需要制定的重要政策，以确保临床团队的所有成员都能正确理解死亡，并对家属要求对已故患者继续进行“治疗”的权力加以一定限制。接下来，我们说明如何最好地让家属为诊断做好准备。然后，我们讨论在告知家属关于DNC的消息时该如何交谈。最后，我们描述如何应对抵制死亡判定的家属。
本文就如何与家属谈论脑死亡向临床医生提供建议。
