Taylor C
Georgetown University, USA.
Image J Nurs Sch. 1995 Winter;27(4):301-6. doi: 10.1111/j.1547-5069.1995.tb00892.x.
Defining medical futility is central to the efforts of clinicians and ethicists who seek to identify the limits of patient autonomy. This article is a critique of current efforts to define and then use policies of medical futility to justify refusing requests for treatment and care that have no perceived medical benefit. After exploring the current definitions of medical futility in the bioethics and clinical literature, comparisons of the advantages and disadvantages of the following three options are provided: allowing patients to decide all but physiologic futility, allowing clinicians to decide futility, and pursuing negotiated compromise. The third option--negotiated compromise--is recommended. A role is developed for nurses in preventing and resolving conflict about futile treatment.
界定医疗无效性是临床医生和伦理学家试图确定患者自主权界限的核心工作。本文对当前界定医疗无效性并进而利用医疗无效性政策来拒绝那些被认为没有医疗益处的治疗和护理请求的努力进行了批判。在探究了生物伦理学和临床文献中当前对医疗无效性的定义后，对以下三种选择的优缺点进行了比较：允许患者决定除生理无效性之外的所有情况、允许临床医生决定无效性以及寻求协商妥协。推荐第三种选择——协商妥协。阐述了护士在预防和解决关于无效治疗的冲突方面所起的作用。
