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临终关怀中关于维持生命治疗的伦理决策:两种观点异同的范围综述

Ethical Decision-Making Regarding Life Sustaining Treatment in End-Of-Life Care: A Scoping Review of the Similarities and Differences Between Two Viewpoints.

作者信息

Larijani Bagher, Mobasher Mina, Zahedi Farzaneh, Tahmasebi Mamak

机构信息

Medical Ethics and History of Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran.

Endocrinology and Metabolism Research Centre, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

Arch Acad Emerg Med. 2024 Nov 21;13(1):e17. doi: 10.22037/aaem.v13i1.2402. eCollection 2025.

Abstract

Decisions on life-sustaining treatment depend on evaluating fundamental ethical principles regarding taking human life. This study aimed to compare the Islamic standpoint with secular views on ethical decision-making in end-of-life care. We conducted a scoping review to analyze and compare articles published in 2000-2022, regarding ethical criteria for withdrawing life-prolonging treatments in dying patients, and the final decision-maker in such cases. The main difference between the two viewpoints, however, lies in the perspective that in Islam to save human life is of utmost importance, and therefore the criteria for treatment benefits, indications, and goals should all be evaluated in the light of this profound Islamic concept. The most significant similarity discovered between the two standpoints was that a terminal patient's wish not to prolong the process of dying should be respected, and the physician's opinion in determining the benefit or futility of treatment is of utmost importance. Comparison of Islamic and Secular perspectives about ethical decision-making in end-of-life care regarding life sustaining treatment indicates that benefits of treatments for patients, and healthcare goals are among the major factors in decision-making according to both viewpoints, and patients, their families, physicians, and the medical team are all involved in making the final decision.

摘要

关于维持生命治疗的决策取决于对涉及夺取人类生命的基本伦理原则的评估。本研究旨在比较伊斯兰教观点与世俗观点在临终关怀伦理决策方面的差异。我们进行了一项范围审查,以分析和比较2000年至2022年发表的关于临终患者停止延长生命治疗的伦理标准以及此类情况下最终决策者的文章。然而,两种观点的主要差异在于,在伊斯兰教中拯救人类生命至关重要,因此治疗益处、适应症和目标的标准都应根据这一深刻的伊斯兰教概念进行评估。两种观点之间发现的最显著相似之处在于,应尊重晚期患者不延长死亡过程的意愿,并且医生在确定治疗的益处或无效性方面的意见至关重要。对伊斯兰教和世俗观点在临终关怀中关于维持生命治疗的伦理决策的比较表明,根据两种观点,治疗对患者的益处和医疗保健目标都是决策的主要因素,并且患者、其家人、医生和医疗团队都参与做出最终决策。

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