临终患者的息镇静: "当其他一切都不起作用时,我们会转向它"
1Program in Medical Ethics and the Division of General Internal Medicine in the Department of Medicine at the University of California San Francisco, USA. bernie@medicine.ucsf.edu
JAMA
|October 13, 2005
概括
息镇静可以缓解其他治疗失败的临终患者的严重症状. 这种道德方法需要明确的沟通和记录意图来缓解痛苦,而不是加快死亡.
科学领域:
- 抚慰性医学是一种缓解性医学.
- 医学伦理 医学伦理
背景情况:
- 临终患者可能会经历难以治疗的症状,尽管专家的息治疗.
- 高剂量的阿片类药物用于缓解疼痛可能会导致诸如肌肉瘤之类的不良影响.
研究的目的:
- 探索息镇静的作用和伦理考虑,作为症状管理的最后手段.
- 突出双重效应学说在正当化息镇静的重要性.
主要方法:
- 一个患有转移性乳腺癌的患者经历了耐火症状的案例说明.
- 对息镇静的伦理框架 (双重效应理论) 的讨论.
- 强调在息镇静中进行沟通和记录.
主要成果:
- 以双重效应理论为指导的息镇静可以是允许的干预措施.
- 清晰的意图来缓解痛苦,而不是加快死亡,至关重要.
- 患者/家人的同意和护理团队之间的清晰沟通是必不可少的.
结论:
- 息镇静是一种伦理上合理的选择,用于垂死患者的耐火症状.
- 了解和记录高剂量镇静剂/阿片类药物管理背后的意图至关重要.
- 开放的沟通解决了息镇静的复杂医疗,伦理和情感方面的问题.
关键词:
死亡和安乐死是死亡和安乐死.相关概念视频
Restorative Care
Restorative care is provided once a patient has been discharged from a healthcare facility and requires additional services. The additional services include home care, rehabilitation programs, and extended care. Restorative care centers help the patient regain their previous level of functioning or acquire a new level of functioning due to the incapacitating effects of a disease or a disability. It aims to assist patients in enhancing their quality of life by encouraging independence,...
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,...
Classification of Illness
The meaning of illness is individualized to each person who experiences an alteration in health. In contrast, disease is a medical term indicating a pathological change in the structure and function of the body or mind. It is a condition that has specific symptoms and boundaries.
An illness is a response to a disease in which the person's level of functioning is changed compared with a previous level. The general classification of illness includes acute and chronic.
Acute illness is severe and...
An illness is a response to a disease in which the person's level of functioning is changed compared with a previous level. The general classification of illness includes acute and chronic.
Acute illness is severe and...
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:
Mitral Regurgitation IV: Nursing Management
Mitral regurgitation (MR) is a condition where the mitral valve does not close properly, leading to the backward flow of blood from the left ventricle into the left atrium during systole. This condition can arise from various causes, including rheumatic fever, infective endocarditis, or degenerative valve disease. Effective nursing management is crucial to optimizing patient outcomes and involves comprehensive assessment and targeted interventions.Comprehensive Patient AssessmentA detailed...
Kubler Ross's Stages of Dying
Elisabeth Kübler-Ross significantly advanced psychology's understanding of the process of dying with her influential book, On Death and Dying (1969). She focused on studying terminally ill individuals and outlined five stages commonly experienced when coping with death: denial, anger, bargaining, depression, and acceptance.
In denial, individuals reject the reality of their condition, often thinking, "This isn't true; I feel fine," as a way to protect themselves from emotional distress. Anger...
In denial, individuals reject the reality of their condition, often thinking, "This isn't true; I feel fine," as a way to protect themselves from emotional distress. Anger...


