Danis M, Patrick D L, Southerland L I, Green M L
Department of Medicine, School of Medicine, University of North Carolina, Chapel Hill 27514.
JAMA. 1988 Aug 12;260(6):797-802.
Medical ethics suggest that life-sustaining treatment decisions should be made with consideration for patients' preferences and quality of life. Patients were interviewed who were at least 55 years old and had experienced medical intensive care at a university hospital during a one-year period to determine their preferences regarding intensive care; family members were interviewed if the patient had died (n = 160). Seventy percent of patients and families were 100% willing to undergo intensive care again to achieve even one month of survival; 8% were completely unwilling to undergo intensive care to achieve any prolongation of survival. Preferences were poorly correlated with functional status or quality of life and were not altered by life expectancy for 82% of respondents. Age, severity of critical illness, length of stay, and charges for intensive care did not influence willingness to undergo intensive care. These data suggest that personal preferences may conflict with any health policy that limits the allocation of intensive care based on age, function, or quality of life.
医学伦理表明，维持生命的治疗决策应考虑患者的偏好和生活质量。对年龄至少55岁且在一年时间内在大学医院接受过医疗重症监护的患者进行了访谈，以确定他们对重症监护的偏好；如果患者已去世，则对其家属进行访谈（n = 160）。70%的患者及其家属表示，哪怕只能多活一个月，也100%愿意再次接受重症监护；8%的患者及其家属完全不愿意接受重症监护以延长任何生存期。偏好与功能状态或生活质量的相关性较差，82%的受访者的偏好不会因预期寿命而改变。年龄、危重病的严重程度、住院时间和重症监护费用均不影响接受重症监护的意愿。这些数据表明，个人偏好可能与任何基于年龄、功能或生活质量来限制重症监护资源分配的卫生政策相冲突。
