伦理咨询对重症监护室中非有益的维持生命治疗的影响:一项随机对照试验
Lawrence J Schneiderman1, Todd Gilmer, Holly D Teetzel
1Department of Family and Preventive Medicine, University of California, San Diego, La Jolla 92093, USA. ljs@ucsd.edu
JAMA
|September 4, 2003
概括
在重症监护室 (ICU) 进行的伦理咨询,减少了无法生存的患者的治疗日数. 这些商有助于解决有关维持生命治疗的冲突.
科学领域:
- 医学伦理 医学伦理
- 关键护理医学 关键护理医学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 伦理咨询越来越多地用于维持生命的治疗冲突.
- 关于这些商结果的数据有限.
研究的目的:
- 评估伦理咨询对重症监护室 (ICU) 维持生命治疗使用的影响.
- 评估对患者结果的影响以及医疗保健提供者和患者/代孕者的看法.
主要方法:
- 一个前性的多中心随机对照试验,涉及7家美国医院的551名患者.
- 经历治疗冲突的患者被随机分配到接受伦理咨询或通常的护理.
- 结果包括ICU日,维持生命的治疗,死亡率和定性反.
主要成果:
- 两组之间整体死亡率没有显著差异.
- 伦理咨询与非幸存者的医院和ICU日数减少有关.
- 在接受咨询的非幸存者中,观察到通风日数显著减少.
结论:
- 伦理咨询有效地解决了关于ICU中可能不有益或不必要的治疗的冲突.
- 在解决复杂的终身护理决策时,协商证明是有价值的.
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