Layson R T, McConnell T
Department of Medicine, University of North Carolina at Chapel Hill, USA.
Arch Intern Med. 1996;156(22):2617-20.
Using cardiopulmonary resuscitation for cardiac or respiratory arrest unless there is an explicit do-not-resuscitate order is a policy adopted by all hospitals. Such a policy usually requires the patient's (or surrogate's) consent for a do-not-resuscitate order to be instituted. This article, however, presents the argument that consent need not always be obtained. In the case discussed, the well-being of the patient, other patients, and the health care providers all support a unilateral decision by the physician not to attempt resuscitation at the time of death. The medical community and society need to acknowledge that such cases exist and to develop policies that respect not only the interests of patients but also those of health care providers and society.
除非有明确的不进行心肺复苏医嘱,否则对心脏骤停或呼吸骤停患者实施心肺复苏是所有医院都采用的一项政策。这样一项政策通常要求患者(或代理人)同意才能下达不进行心肺复苏的医嘱。然而,本文提出了一种观点,即不一定总是需要获得同意。在所讨论的案例中,患者、其他患者以及医护人员的福祉都支持医生在患者死亡时做出不尝试复苏的单方面决定。医学界和社会需要承认存在此类情况,并制定不仅尊重患者利益,而且尊重医护人员和社会利益的政策。