Lee M A, Cassel C K
West J Med. 1984 Jan;140(1):117-22.
Practicing physicians are frequently faced with the question of whether or not to institute cardiopulmonary resuscitation in case of cardiac or respiratory arrest in a patient in hospital. Medical training has usually not included any systematic analysis of this issue from either an ethical or a legal standpoint. Many physicians may be unaware that ethical and legal principles, as well as professional guidelines, exist to guide such decision making. In practice, physicians make this decision without the benefit of training in ethical analysis. The problem is especially acute in teaching hospitals when young physicians unacquainted with formal ethics or the law must often make decisions emergently. Studies show some discrepancy between ethical and legal principles and the actual decision making by physicians. For this reason, we recommend an approach that will enable physicians to make and implement decisions not to resuscitate that are consistent with current ethical and legal standards.
对于医院里心脏骤停或呼吸骤停的患者,是否应该实施心肺复苏术。医学培训通常并未从伦理或法律角度对这一问题进行任何系统分析。许多医师可能并未意识到存在伦理和法律原则以及专业指南来指导此类决策。在实际操作中,医师们在没有接受伦理分析培训的情况下做出这一决定。在教学医院,这个问题尤为尖锐,因为不熟悉正式伦理或法律的年轻医师常常必须紧急做出决策。研究表明,伦理和法律原则与医师的实际决策之间存在一些差异。因此,我们推荐一种方法,使医师能够做出并实施符合当前伦理和法律标准的不进行复苏的决策。