我们都应该在睡眠中死去吗? 缓和镇静的正常化问题
Johannes J M van Delden1, Madelon T Heijltjes1, Rowan H Harwood2
1Department of Bioethics and Health Humanities, UMC Utrecht, Julius Center for Health Sciences and Primary Care, PO Box 85500, 3508 GA Utrecht, the Netherlands.
用于管理垂死患者的痛苦的息镇静剂已经增加,可能从最后的手段转变为加速死亡的手段. 虽然它可以提供和平,但仔细管理期望和通信损失至关重要.
科学领域:
- 抚慰性护理是一种缓解性护理.
- 医学伦理 医学伦理
- 生命末期症状管理 生命末期症状管理
背景情况:
- 息镇静是一种干预措施,用于在其他疗法失败时管理临终患者的严重痛苦.
- 有证据表明,镇静剂的使用量有所增加,这引发了有关其作用和潜在滥用的疑问.
- 镇静剂可能被认为是一种"和平死亡"或加快死亡过程的方法.
研究的目的:
- 分析息镇静的不断变化的作用和伦理考虑.
- 检查症状缓解和潜在的负面后果,如沟通丧失之间的平衡.
- 要区分适当的使用与使镇静药物正常化,作为加速死亡的手段.
主要方法:
- 审查当前的做法和围绕息镇静的伦理辩论.
- 在终身护理中使用镇静的趋势分析.
- 讨论临床情景和伦理警告.
主要成果:
- 镇静剂的使用量稳步增加,其指示可能从缓解症状转变为加速死亡.
- 虽然镇静剂可以提供舒适和'和平'的死亡,但它带有道德风险,包括缩短寿命和通信损失.
- 持续深度镇静和安乐死之间的界限需要谨慎的伦理导航.
结论:
- 缓解性镇静可以在伦理上作为最后的手段来治疗症状,只要它是必要的和相称的.
- 持续的深度镇静在某些特定情况下可能是适当的,但它的使用必须遵守严格的标准.
- 拒绝将镇静作为"睡觉时死亡"的常规方法的规范化,对于维持息治疗的伦理标准至关重要.
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