VandeKieft Gregg K
Providence St Peter Hospital, 413 Lilly Road NE, Olympia, WA 98506.
FP Essent. 2020 Nov;498:32-36.
Medical aid in dying (MAID) is a practice in which a physician provides a competent adult with a terminal illness with a prescription for a lethal dose of a drug at the request of the patient, which the patient intends to use to end his or her life. MAID currently is legal in nine states and the District of Columbia. The most common concerns leading to requests for MAID include loss of autonomy, loss of ability to participate in activities that make life enjoyable, and loss of dignity. MAID remains controversial. Physicians can choose not to participate in MAID and many are prohibited from participating by their employers. Family physicians should have the knowledge and skills to respond to inquiries about MAID in a compassionate, patient-centered manner. Clinicians should be familiar with the legal status of MAID in the state in which they practice, understand eligibility requirements for participation, have access to resources to support patients and clinicians, and be able to apply various communication strategies to MAID discussions. A thoughtful exploration of what led the patient to inquire about MAID will allow the physician to better understand and respond to patient concerns regarding the final months of life.
医疗协助死亡（MAID）是一种做法，即医生应患有绝症的有行为能力的成年人的请求，为其开具一剂致命剂量药物的处方，患者打算用该药物结束自己的生命。目前，MAID在九个州和哥伦比亚特区是合法的。导致请求MAID的最常见担忧包括失去自主权、失去参与使生活愉快的活动的能力以及失去尊严。MAID仍然存在争议。医生可以选择不参与MAID，而且许多医生被雇主禁止参与。家庭医生应具备以富有同情心、以患者为中心的方式回应有关MAID询问的知识和技能。临床医生应熟悉其执业所在州MAID的法律地位，了解参与的资格要求，能够获取支持患者和临床医生的资源，并能够在MAID讨论中应用各种沟通策略。对促使患者询问MAID的原因进行深入探究，将使医生能够更好地理解并回应患者对生命最后几个月的担忧。
