Mead G E, Turnbull C J
Department of Geriatric Medicine, University of South Manchester.
J Med Ethics. 1995 Feb;21(1):39-44. doi: 10.1136/jme.21.1.39.
One hundred inpatients on an acute hospital elderly care unit and 43 of their relatives were interviewed shortly before hospital discharge. Eighty per cent of elderly patients and their relatives were aware of cardiopulmonary resuscitation (CPR). Television drama was their main source of information. Patients and relatives overestimated the effectiveness of CPR. Eighty-six per cent of patients were willing to be routinely consulted by doctors about their own CPR status, but relatives were less enthusiastic about routine consultation. Patients' and relatives' views about the appropriateness of CPR did not differ significantly. Seventeen percent of patients did not desire CPR. However, 64 per cent of patients were ultimately willing to follow their doctor's advice about the appropriateness of CPR. The conclusion reached is that mentally competent, elderly patients but not their relatives should be routinely consulted about their own desire for CPR in order to avoid resuscitating patients against their wishes. Further research is required to find out how patients would feel about resuscitation if they were terminally ill or chronically confused, and how carers would feel about resuscitating such patients.
在一家急症医院的老年护理病房,对100名住院患者及其43名亲属在出院前不久进行了访谈。80%的老年患者及其亲属了解心肺复苏术(CPR)。电视剧是他们主要的信息来源。患者和亲属高估了心肺复苏术的有效性。86%的患者愿意医生就其自身的心肺复苏状态进行常规咨询,但亲属对常规咨询的热情较低。患者和亲属对心肺复苏术适当性的看法没有显著差异。17%的患者不希望进行心肺复苏。然而,64%的患者最终愿意听从医生关于心肺复苏术适当性的建议。得出的结论是,为了避免违背患者意愿对其进行复苏,对于精神健全的老年患者而非其亲属,应就其自身对心肺复苏的意愿进行常规咨询。还需要进一步研究,以了解如果患者身患绝症或长期神志不清,他们对复苏会有何感受,以及护理人员对复苏这类患者会有何感受。