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在分诊情况下从患者身上撤出重症监护。

Withdrawing critical care from patients in a triage situation.

机构信息

School of Bioethics, Pontificio Ateneo Regina Apostolorum, Via degli Aldobrandeschi 190, 00163, Rome, Italy.

出版信息

Med Health Care Philos. 2021 Jun;24(2):205-211. doi: 10.1007/s11019-020-09999-4. Epub 2021 Jan 4.

Abstract

The advent of COVID-19 has been the occasion for a renewed interest in the principles governing triage when the number of critically ill patients exceeds the healthcare infrastructure's capacity in a given location. Some scholars advocate that it would be morally acceptable in a crisis to withdraw resources like life support and ICU beds from one patient in favor of another, if, in the judgment of medical personnel, the other patient has a significantly better prognosis. The paper examines the arguments for and against this approach from the point of view of natural law theory, especially using the principle of double effect. We conclude that it is inadmissible to withdraw life-saving medical interventions from patients who are still benefiting from them, on the sole grounds that other patients might benefit more. Those who are currently using such technology should only interrupt their treatment if, in the judgment of medical personnel and, if possible, taking into account the wishes and needs of the patient and his family, the treatment is deemed futile, burdensome, or disproportionate.

摘要

COVID-19 的出现再次引发了人们对分诊原则的关注,即在特定地点,重症患者人数超过医疗基础设施的承载能力时。一些学者主张,在危机中,如果医务人员判断另一名患者的预后明显更好,从一名患者身上撤回生命支持和 ICU 床位等资源,在道德上是可以接受的。本文从自然法理论的角度,特别是利用双重效应原则,对这种方法的利弊进行了论证。我们的结论是,仅仅因为其他患者可能受益更多,就从仍从中受益的患者身上撤回救生医疗干预措施是不可接受的。只有在医务人员判断(如果可能的话,还应考虑患者及其家属的意愿和需求)治疗无效、负担过重或不成比例的情况下,目前正在使用此类技术的人才应中断治疗。

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Withdrawing critical care from patients in a triage situation.在分诊情况下从患者身上撤出重症监护。
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