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父母对其患有严重智力和多重残疾的老年子女的与生死相关的医疗决策的看法:一项定性研究。

Parents' views on medical decisions related to life and death for their ageing child with profound intellectual and multiple disabilities: A qualitative study.

机构信息

Department of Ethics, Law & Humanities, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.

Department of Mediating Good Life, Section of Spiritual Care & Chaplaincy Studies, Protestant Theological University, Groningen, the Netherlands.

出版信息

Res Dev Disabil. 2022 Feb;121:104154. doi: 10.1016/j.ridd.2021.104154. Epub 2021 Dec 23.

Abstract

BACKGROUND

The increased life expectancy of persons with profound intellectual and multiple disabilities (PIMD) raises questions regarding the medical decisions related to life and death, made on their behalf during their later lives. However, little is known about how parents make such decisions for their ageing child.

AIM

Explore parents' views on medical decisions related to life and death for their ageing child with PIMD.

METHODS

We interviewed 27 parents of persons with PIMD (≥ 15 years) and analyzed the data thematically.

RESULTS

Parents who were convinced that their ageing child's quality of life (QoL) was good, stated that their child "deserved the same treatment as any other person". Others rejected life-prolonging treatments for their child because they believed such treatment would diminish their child's QoL. Some of the parents who thought their child's QoL was poor, mentioned that withholding treatment is only an option in a crisis situation and contemplated other options to shorten their child's life.

CONCLUSIONS

Parents feel equipped to take on a central role in medical decisions related to life and death for their ageing child with PIMD, and desire understanding from medical professionals for their views on their child's interests, which sometimes includes physician-assisted death.

摘要

背景

智障和多重残疾人士(PIMD)的预期寿命延长,引发了关于在他们晚年代表他们做出与生死相关的医疗决策的问题。然而,对于父母如何为他们年长的残疾子女做出这些决策,我们知之甚少。

目的

探讨父母对其患有 PIMD 的年长子女的与生死相关的医疗决策的看法。

方法

我们采访了 27 名患有 PIMD(≥15 岁)的人士的父母,并对数据进行了主题分析。

结果

坚信自己年长的子女生活质量(QoL)良好的父母表示,他们的孩子“应该得到与其他人一样的待遇”。其他人则因为认为这种治疗会降低孩子的 QoL 而拒绝为孩子延长生命的治疗。一些认为孩子 QoL 较差的父母则表示,在危机情况下,不进行治疗只是一种选择,并考虑了缩短孩子生命的其他选择。

结论

父母认为自己有能力在与患有 PIMD 的年长子女的生死相关的医疗决策中扮演核心角色,并希望医疗专业人员理解他们对孩子利益的看法,其中有时包括医生协助死亡。

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