Gromb S, Manciet G, Descamps A
Bordeaux University Hospital, Bordeaux Teaching Hospital, Pessac, France.
J Med Ethics. 1997 Aug;23(4):233-8. doi: 10.1136/jme.23.4.233.
The authors discuss law and ethics when medical decisions are to be taken by patients who are unable in any valid sense to express their own wishes. The main problem in legal terms is to protect an individual's free will as far as possible and ensure that his or her wishes, if known, are respected. If a patient's independent wishes cannot be known, then we must at least ensure that nothing is imposed which is not in his interest. Legal measures, however, are far from adequate in resolving all the concrete problems that emerge. The field of ethics does bring some better adapted solutions, but none is laid down in law. One such approach, involving a multidisciplinary advisory group in a department of geriatrics, is discussed.
作者们讨论了在患者无法以任何有效方式表达自身意愿时做出医疗决策的法律与伦理问题。从法律角度来看，主要问题是尽可能保护个人的自由意志，并确保其意愿（若已知）得到尊重。如果患者的独立意愿无法得知，那么我们至少必须确保不施加任何不符合其利益的事情。然而，法律措施在解决出现的所有具体问题方面远远不够。伦理领域确实带来了一些更适用的解决方案，但没有一个是法律规定的。本文讨论了一种方法，即在老年医学科设立一个多学科咨询小组。
