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[在重症监护病房中死亡]

[Dying in the intensive care unit].

作者信息

Salomon Fred

机构信息

Mobile Ethikberatung in Lippe (MELIP), Tulpenweg 21, 32657, Lemgo, Deutschland.

出版信息

Med Klin Intensivmed Notfmed. 2025 Sep 1. doi: 10.1007/s00063-025-01319-z.

Abstract

Intensive care medicine symbolizes a form of medicine that seeks to prevent or overcome illness and life-threatening situations in order to enable a life that is acceptable to the patient. Despite the curative goal, dying and death are unavoidable. For ethically founded intensive care medicine, treatment goals must be agreed upon. The use of all resources is justified by their alignment with these goals and their desire for the patient. The indication and patient consent must be continually reviewed. If the goals are no longer achievable or desired by the patient, dying must be permitted. Then the steps for withholding treatment and palliative care must be organized, and end-of-life-care must be facilitated by relatives and the team. These decisions require not only professional but also communicative competence. Advance directives and ethics advice can be helpful. A case study illustrates this.

摘要

重症监护医学代表了一种医学形式,旨在预防或克服疾病及危及生命的情况,以使患者能够过上可接受的生活。尽管有治愈的目标,但死亡是不可避免的。对于基于伦理的重症监护医学而言,必须就治疗目标达成一致。所有资源的使用都因其与这些目标的一致性以及对患者的意愿而具有合理性。必须持续审查适应症和患者的同意情况。如果目标不再能够实现或患者不再期望,就必须允许死亡。然后,必须安排停止治疗和姑息治疗的步骤,亲属和团队必须协助提供临终关怀。这些决策不仅需要专业能力,还需要沟通能力。预先指示和伦理建议可能会有所帮助。一个案例研究说明了这一点。

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