Howard Stephen, Tam Ryan, Naser Mohammad, Jawish Mohammad
Physical Medicine and Rehabilitation, Lake Erie College of Osteopathic Medicine, Elmira, USA.
Physical Medicine and Rehabilitation, Rochester Regional Health, Rochester, USA.
Cureus. 2024 Apr 30;16(4):e59351. doi: 10.7759/cureus.59351. eCollection 2024 Apr.
Stroke is a leading cause of long-term disability in the United States that can lead to loss of function and consciousness. With the abrupt onset of the brain insult, end-of-life care discussions are an important attribute of respecting the patient's best wishes and upholding the ethical principles of autonomy, beneficence, nonmaleficence, fidelity, and justice. Furthermore, the topic of extending life support to individuals with poor prognostic factors of improvement in quality of life and functional recovery has been a continued topic of debate due to a multitude of factors, including the wishes of the patient, familial emotions, cultural beliefs, and religious influences. This case involves a patient who suffered from a left pontine stroke, necessitating multiple end-of-life care conversations. Despite no clinical improvement for several years, the patient required prolonged hospitalization and ongoing ventilator use.
中风是美国长期残疾的主要原因,可导致功能丧失和意识丧失。随着脑部损伤的突然发生,临终关怀讨论是尊重患者最佳意愿以及秉持自主、行善、不伤害、忠诚和公正等伦理原则的重要方面。此外,由于多种因素,包括患者的意愿、家庭情感、文化信仰和宗教影响,对于向生活质量和功能恢复预后因素较差的个体延长生命支持这一话题一直存在争议。本病例涉及一名患有左侧脑桥中风的患者,需要进行多次临终关怀谈话。尽管多年来临床没有改善,但患者仍需要长期住院并持续使用呼吸机。