Ardagh M
Christchurch School of Medicine, New Zealand.
J Med Ethics. 1997 Oct;23(5):289-94. doi: 10.1136/jme.23.5.289.
Endotracheal intubation (ETI) is a valuable procedure which must be learnt and practised, and performing ETI on cadavers is probably the best way to do this, although lesser alternatives do exist. Performing ETI on a cadaver is viewed with a real and reasonable repugnance and if it is done without proper authorisation it might be illegal. Some form of consent is required. Presumed consent would preferably be governed by statute and should only occur if the community is well informed and therefore in a position of being able to decline. Currently neither statute nor adequate informing exists. Endotracheal intubation on the newly dead may be justifiable according to a Guttman scale if the patient has already consented to organ donation and if further research supports the relevance of the Guttman scale to this question. A "mandated choice" with prior individual consent as a matter of public policy is the best of these solutions, however until such a solution is in place we may not practise endotracheal intubation on the newly dead.
气管插管术(ETI)是一项必须学习和实践的重要操作,在尸体上进行气管插管术可能是做到这一点的最佳方法,尽管也存在其他不太理想的选择。在尸体上进行气管插管术会引起人们真实且合理的反感,如果未经适当授权就进行,可能是违法的。需要某种形式的同意。推定同意最好由法规来规范,并且只有在社区得到充分告知从而能够拒绝的情况下才应发生。目前既没有相关法规,也没有充分的告知。如果患者已经同意器官捐赠,并且进一步的研究支持古特曼量表与这个问题的相关性,那么根据古特曼量表,对刚死亡的患者进行气管插管术可能是合理的。然而,作为一项公共政策,以事先获得个人同意为前提的“强制选择”是这些解决方案中最好的,但在这样的解决方案到位之前,我们不得对刚死亡的患者进行气管插管术。