临终决策：关于维持生命治疗的专业观点
Decisions near the end of life: professional views on life-sustaining treatments.
作者信息
Solomon M Z, O'Donnell L, Jennings B, Guilfoy V, Wolf S M, Nolan K, Jackson R, Koch-Weser D, Donnelley S
机构信息
Decisions Near the End of Life Program, Education Development Center Inc, Newton, MA 02160.
出版信息
Am J Public Health. 1993 Jan;83(1):14-23. doi: 10.2105/ajph.83.1.14.
OBJECTIVES
How do health care professionals assess the care of hospital patients near the end of life? Are physicians and nurses aware of and in agreement with national recommendations regarding patients' rights to forgo life-sustaining medical treatments and to receive adequate pain control?
METHODS
We surveyed 687 physicians and 759 nurses in 5 hospitals.
RESULTS
Almost half (47%) of all respondents and fully 70% of the house officers reported that they had acted against their conscience in providing care to the terminally ill. Four times as many respondents were concerned about the provision of overly burdensome treatment than about undertreatment.
CONCLUSIONS
In summary, many physicians and nurses were disturbed by the degree to which technological solutions influence care during the final days of a terminal illness and by the undertreatment of pain. However, changes in the care of dying patients may not have kept pace with national recommendations, in part because many physicians and nurses disagreed with and may have been unaware of some key guidelines, such as the permissibility of withdrawing treatments.
目的
医护人员如何评估临近生命末期的住院患者的护理情况？医生和护士是否了解并认同关于患者放弃维持生命的医疗治疗及获得充分疼痛控制权利的国家建议？
方法
我们对5家医院的687名医生和759名护士进行了调查。
结果
几乎一半（47%）的受访者以及整整70%的住院医生表示，他们在为绝症患者提供护理时违背了自己的良心。担心提供过度负担治疗的受访者是担心治疗不足的受访者的四倍。
结论
总之，许多医生和护士对技术手段在绝症患者最后日子里对护理的影响程度以及疼痛治疗不足感到不安。然而，临终患者护理方面的变化可能没有跟上国家建议的步伐，部分原因是许多医生和护士不同意且可能未意识到一些关键指南，比如停止治疗的可允许性。
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