J Med Ethics. 1977 Dec;3(4):189-93. doi: 10.1136/jme.3.4.189.
The case of a patient with an incurable condition which was bound to deteriorate is discussed in the light of two conceptions of medical care: the first, the traditional one of treating with all the means at the doctor's disposal until death wins', the other to let go' of his skills for the greater good of the patient and his family. The second course was adopted by the doctor looking after the patient described here after careful consultation with the daughter, who was living in her father's house and willing to look after him as long as was necessary. On the whole the doctor is commended by those contributing to the case conference, although it is recognized that the course of `action' adopted is still not yet fully accepted in modern society. (Both lay and medical opinion, however, seems to be moving towards that way of thinking.) Susan Thorne's contribution makes the suggestion that in cases where there seems to be a moral or ethical dilemma there might be some kind of counsellor available for those concerned in making the ethical and medical decisions, and in the addendum to the case conference a former general practitioner, now practising as a hospital doctor, points to the two different medical cultures exemplified by the attitudes of American and British doctors.
针对一位身患绝症且病情注定会恶化的患者情况,依据两种医疗观念展开了讨论:第一种是传统观念,即运用医生所能掌握的一切手段进行治疗,直至死亡“获胜”;另一种是为了患者及其家人的更大利益,放弃医生的治疗技能。在这里描述的照顾该患者的医生,在与住在父亲家中且愿意在必要时照顾他的女儿仔细商议后,采取了第二种做法。总体而言,参与病例讨论会的人对这位医生表示赞赏,尽管大家意识到所采取的“行动”方式在现代社会尚未被完全接受。(不过,外行和医学观点似乎都在朝着那种思维方式转变。)苏珊·索恩的发言提出,在似乎存在道德或伦理困境的情况下,可能会有某种顾问为那些参与做出伦理和医疗决策的人提供帮助。在病例讨论会的附录中,一位从前的全科医生(现作为医院医生行医)指出了美国和英国医生态度所体现的两种不同医疗文化。