Shelton W
Albany Medical College, NY 12208, USA.
Theor Med Bioeth. 1998 Aug;19(4):383-400. doi: 10.1023/a:1009908016744.
This paper attempts to provide a descriptive theoretical overview of the medical futility debate. I will first argue that quantitative data cannot alone resolve the medical futility debate. I will then examine two aspects of medical futility, which I call the prospective and immediate, respectively. The first involves making prospective factual and value judgments about the efficacy of proposed medical interventions, while the latter involves making value judgments about ongoing medical conditions where the clinical data are clear. At stake is the nature and scope of individual rights. Thus, I maintain there is an undeveloped aspect to the medical futility debate and, briefly, analyze two political perspectives which give rise to different understandings of medical futility. The view that I will defend is that only a system with defined collective goals can accommodate a normative concept of medical futility. These larger questions are the value options which if unaddressed, may be settled by default of economic grounds.
本文试图对医疗无效性辩论进行描述性的理论概述。我将首先论证，仅凭定量数据无法解决医疗无效性辩论。然后，我将审视医疗无效性的两个方面，分别称之为前瞻性和即时性。第一个方面涉及对拟议医疗干预措施的疗效做出前瞻性事实判断和价值判断，而后者涉及对临床数据明确的现有医疗状况做出价值判断。所涉及的是个人权利的性质和范围。因此，我认为医疗无效性辩论存在一个未得到充分探讨的方面，并简要分析两种政治观点，它们对医疗无效性产生了不同的理解。我将捍卫的观点是，只有一个具有明确集体目标的系统才能容纳医疗无效性的规范概念。这些更大的问题是价值选择，如果不加以解决，可能会因经济原因而默认解决。
