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医疗无效与临终患者的护理

Medical futility and care of dying patients.

作者信息

Jecker N S

机构信息

Dept. of Medical History and Ethics, University of Washington School of Medicine, Seattle 98195-7120, USA.

出版信息

West J Med. 1995 Sep;163(3):287-91.

PMID:7571593
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC1303054/
Abstract

In this article, I address ethical concerns related to forgoing futile medical treatment in terminally ill and dying patients. Any discussion of medical futility should emphasize that health professionals and health care institutions have ethical responsibilities regarding medical futility. Among the topics I address are communicating with patients and families, resolving possible conflicts, and developing professional standards. Finally, I explore why acknowledging the futility of life-prolonging medical interventions can be so difficult for patients, families, and health professionals.

摘要

在本文中，我探讨了与放弃终末期和濒死患者的无效医疗治疗相关的伦理问题。任何关于医疗无效性的讨论都应强调，医疗专业人员和医疗机构在医疗无效性方面负有伦理责任。我探讨的主题包括与患者及家属沟通、解决可能出现的冲突以及制定专业标准。最后，我探究了为何承认延长生命的医疗干预措施无效，对患者、家属和医疗专业人员而言会如此困难。

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本文引用的文献

1
Stopping treatment on grounds of futility: a role for institutional policy.基于无意义而停止治疗：机构政策的作用。
St Louis Univ Public Law Rev. 1992;11(2):481-97.
2
Futility in practice.实践中的无意义性。
Arch Intern Med. 1993 Feb 22;153(4):437-41.
3
Decisions near the end of life: professional views on life-sustaining treatments.临终决策：关于维持生命治疗的专业观点
Am J Public Health. 1993 Jan;83(1):14-23. doi: 10.2105/ajph.83.1.14.
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Predicting the outcome of unsuccessful prehospital advanced cardiac life support.预测院外高级心脏生命支持未成功的结果。
JAMA. 1993;270(12):1433-6.
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An ethical analysis of the use of 'futility' in the 1992 American Heart Association Guidelines for cardiopulmonary resuscitation and emergency cardiac care.对1992年美国心脏协会心肺复苏和急诊心脏护理指南中“无效治疗”使用情况的伦理分析。
Arch Intern Med. 1993 Oct 11;153(19):2195-8.
6
Beyond futility to an ethic of care.从徒劳到关怀伦理。
Am J Med. 1994 Feb;96(2):110-4. doi: 10.1016/0002-9343(94)90130-9.
7
Decisions to limit or continue life-sustaining treatment by critical care physicians in the United States: conflicts between physicians' practices and patients' wishes.美国重症监护医师关于限制或继续维持生命治疗的决策：医师的做法与患者意愿之间的冲突。
Am J Respir Crit Care Med. 1995 Feb;151(2 Pt 1):288-92. doi: 10.1164/ajrccm.151.2.7842181.
8
Withdrawal or withholding of treatment at the end of life. Results of a nationwide study.临终时治疗的撤除或放弃。一项全国性研究的结果。
Arch Intern Med. 1995 Feb 13;155(3):286-92.
9
The cardiopulmonary resuscitation-not-indicated order: futility revisited.心肺复苏不适用医嘱：对无效性的再探讨
Ann Intern Med. 1995 Feb 15;122(4):304-8. doi: 10.7326/0003-4819-122-4-199502150-00011.
10
Use of the medical futility rationale in do-not-attempt-resuscitation orders.在“不要尝试复苏”医嘱中使用医疗无效性理论。
JAMA. 1995 Jan 11;273(2):124-8.

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