Norup M
Department of Medical Philosophy and Clinical Theory, University of Copenhagen, Panum Institute, Denmark.
J Med Ethics. 1998 Jun;24(3):200-6. doi: 10.1136/jme.24.3.200.
To study attitudes in the Danish population towards treatment of severely handicapped and extremely preterm infants and to define areas of consensus and controversy.
Mail-delivered questionnaire.
Denmark. Survey sample--A random sample of 1080 persons aged from 18 to 45 years.
The overall response rate was 68%. There was strong consensus (more than 75% agreement) that life-prolonging treatment should be provided for an infant born after 24 weeks' gestation with respiratory distress and, for an infant with myelomeningocele, when the parents were in favour of treatment. Further, there was almost uniform agreement that not all infants should be treated no matter how serious the condition. Major controversies concerned the severity of a condition needed to justify omission of life-prolonging treatment, the role of parental attitude and the options in non-treatment cases. Forty-six per cent thought it ought to be legal to kill the infant in at least some of these cases.
Although the study revealed wide divergences of opinion with regard to questions about limits of treatment and about end-of-life decisions it also showed that there was general acceptance both that life-prolonging treatment ought to be provided even in relatively severe cases if this was in accordance with parental wishes, and that life should not be saved at all costs.
研究丹麦人群对重度残疾及极早产儿治疗的态度,并确定达成共识和存在争议的领域。
邮寄问卷。
丹麦。调查样本——1080名年龄在18至45岁之间的随机抽样人员。
总体回复率为68%。对于孕周24周后出生且患有呼吸窘迫的婴儿,以及患有脊髓脊膜膨出且父母赞成治疗的婴儿,应提供延长生命的治疗,这一点存在强烈共识(超过75%的人同意)。此外,几乎一致认同并非所有婴儿都应接受治疗,无论病情多么严重。主要争议涉及证明可省略延长生命治疗所需病情的严重程度、父母态度的作用以及不治疗情况下的选择。46%的人认为在至少某些此类情况下杀死婴儿应属合法。
尽管该研究揭示了在治疗限度和临终决策问题上存在广泛的意见分歧,但也表明人们普遍接受:如果符合父母意愿,即使在相对严重的情况下也应提供延长生命的治疗,而且不应不惜一切代价挽救生命。