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在自愿停止饮食后 (VSED) 填写死亡证明的挑战
Takeshi Uemura1, Benjamin J Krohmal2, Masaya Higuchi3
1Brookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Journal of the American Medical Directors Association
|July 30, 2023
概括
自愿停止饮食 (VSED) 意识正在增长,但死亡证明带来了挑战. 将VSED视为自杀行为可能会阻止提供者,并使家庭陷入困境,需要改进系统.
科学领域:
- 医学伦理 医学伦理
- 在生命末期的护理.
- 公共卫生政策 公共卫生政策
背景情况:
- 自愿停止饮食 (VSED) 越来越多地被认为是对无法忍受的痛苦的终身选择.
- 有限的文献讨论了VSED之后的死亡证明的复杂性.
- 对VSED的分类 (自然死亡与自杀) 缺乏共识,造成了挑战.
研究的目的:
- 检查VSED后完成死亡证明的挑战.
- 分析将VSED归类为自杀对医疗保健提供者和家庭的影响.
- 在VSED案件中提出解决死亡证明问题的策略.
主要方法:
- VSED的案例研究介绍与自杀方式的死亡指定.
- 关于VSED死亡认证方面的挑战和问题的文献综述.
- 对自杀指定的潜在影响的分析.
主要成果:
- VSED的死亡证明可能会被提交给法医,通常会导致自杀的指定.
- 自杀的指定可能会导致提供者不情愿,机构担忧和道德困扰.
- 指定给幸存的家庭带来了情感和实际的负担.
结论:
- 目前对VSED的死亡认证实践存在重大挑战.
- 应对这些挑战需要仔细考虑现有系统,法律豁免或系统变化.
- 为了开发有效的解决方案,多学科辩论至关重要.
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