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避免无效的临终关怀:分诊的教训?

Avoiding Ineffective End-of-Life Care: A Lesson from Triage?

出版信息

Hastings Cent Rep. 2020 May;50(3):71-72. doi: 10.1002/hast.1141.

Abstract

Ethicists and physicians all over the world have been working on triage protocols to plan for the possibility that the Covid-19 pandemic will result in shortages of intensive care unit beds, ventilators, blood products, or medications. In reflecting on those protocols, many health care workers have noticed that, outside the pandemic shortage situation, we routinely supply patients in the ICU with invasive and painful care that will not help the patients survive even their hospitalization. This is the kind of pointless care that even the most basic protocol would triage against. Perhaps this widespread reflection on triage standards will draw our attention to our ongoing custom of supplying burdensome and inefficacious care to those near the end of life-care that most health care providers would not want for themselves. This essay argues that reflecting on triage could help us improve end-of-life care.

摘要

世界各地的伦理学家和医生一直在制定分诊方案,以应对新冠疫情可能导致重症监护病房床位、呼吸机、血液制品或药物短缺的情况。在反思这些方案时,许多医护人员注意到,在大流行短缺情况之外,我们通常会为重症监护病房的患者提供侵入性和痛苦的治疗,这些治疗甚至无法帮助患者在住院期间存活。这是一种毫无意义的治疗,即使是最基本的方案也会对其进行分诊。也许这种对分诊标准的广泛反思将引起我们对我们为生命末期患者提供负担沉重和无效的护理的持续关注——大多数医疗保健提供者都不希望自己接受这种护理。本文认为,反思分诊标准可能有助于我们改善临终关怀。

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