生命維持介入を必要とする末期病患者を,生命維持介入を必要としない患者と等しくすることは,臨床的に意味があるのか?
1Program in Medical Ethics, University of California, San Francisco, USA. ann_alpers@ucsfdgim.ucsf.edu
JAMA
|June 4, 1997
まとめ
2つの米国の裁判所によると,有能で終末期疾患の患者は,医師による自殺を支援する憲法上の権利を有している可能性がある. この分析は,裁判所の推論が臨床的に欠陥があり,終末期ケアを損なう可能性があると主張しています.
科学分野:
- 医療倫理 医療倫理について
- 法医学は法医学である.
- 緩和ケアとは,緩和ケアです.
背景:
- 米国の2つの控訴裁判所は,有能で末期疾患の患者の医師による自殺に対する憲法上の権利を認めている.
- これらの事件は米国最高裁判所で審理されており,判決は間もなく発表される見込みです.
研究 の 目的:
- 生命維持装置を使用している患者と生命維持装置を必要としない患者を等同視する法的推論を生命の終わりの決定の文脈で分析する.
- 医師による自殺の法的同等性の臨床的妥当性を批判的に評価する.
主な方法:
- 医師による自殺支援に関する裁判所の判決の分析.
- 終末期疾患のケアにおける臨床シナリオの検討.
- 司法推論の法的・倫理的批判.
主要な成果:
- 生命維持装置の患者が生命維持装置の無い患者と同等であるという裁判所の主張は,欠陥のある前提に基づいています.
- この推論は,終末期の臨床ケアと患者の自律性のニュアンスを説明できない.
結論:
- 医療助成自殺に関する裁判所の法的推論は,臨床的に妥当ではない.
- この推論の含意は,末期病患者のケア品質に悪影響を及ぼす可能性があります.
関連する概念動画
Continuing Care
Continuing care describes the variety of health, personal, and social services provided over a prolonged period. The need for continuing care is increasing because people are living longer. Many people do not have families or others to care for them. Continuing care is mainly for patients who are disabled, functionally dependent, or suffering from a terminal disease. It is available within institutional settings or in homes. Examples include nursing centers or facilities, assisted living,...
Patient-centered Care
Patient-centered care involves delivering care beyond inpatient hospitalization. Reflective practice can enhance a patient-centered approach. Reflective practice is a process of reasoning that considers all aspects of the present situation, including practicalities, learning from personal practice, and consideration of patient needs. Patients appreciate care decisions made while considering their input. Involving the patient in their care provides the patient with a sense of contribution rather...
Nursing Interventions II: Selecting and Classifying the Nursing Interventions
Creating and executing a nursing diagnosis helps nurses plan care and guide patient, family, and community interventions. They are developed based on a patient's physical evaluation and support measuring the outcomes. It is not recommended to select random interventions throughout the planning process. Instead, consider the following six essential factors when choosing interventions:
Ethical Issues
Nurses are essential in patient care, upholding the ethical principles of their profession and effectively navigating ethical dilemmas. Neglecting ethical issues can lead to inadequate patient care, compromised therapeutic relationships, and moral distress among healthcare workers.
Ethical Concerns in Healthcare:
Ethical Concerns in Healthcare:
Ethical Dilemmas II
Resolving an ethical dilemma in healthcare involves a systematic approach that considers every aspect of the issue, respecting both the patient's needs and values and the healthcare professional's ethical obligations. Here are potential steps to resolve an ethical dilemma:
Bioequivalence of Drugs: Drugs with Multiple Indications
The concept of therapeutic equivalence (TE) in drugs with multiple indications is complex. A generic drug may be therapeutically equivalent to a brand-name product for one specific indication, but this doesn't necessarily mean it's equivalent for all other indications. Evidence of TE in one patient group and bioequivalence shown in healthy volunteers can support—but not confirm—TE for other indications. However, definitive proof requires individual clinical studies for each indication due to...
