与"关于维持生命治疗和改善指导的决定法"相关的问题
Dae Seog Heo1, Shin Hye Yoo2, Bhumsuk Keam2,3
1Patient-Centered Clinical Research Coordinating Center, National Evidence-based Healthcare Collaborating Agency, Korea.
Journal of hospice and palliative care
|September 7, 2023
概括
"关于维持生命治疗的决定法"的遵守率很低. 需要进行修订,以澄清终端阶段,扩大符合条件的机构,并简化患者自主决策过程.
科学领域:
- 医疗法 法律 医疗法
- 生物伦理学生物伦理学
- 在生命末期的护理.
背景情况:
- 自2018年以来,关于维持生命治疗 (LST) 决策的法案一直在活跃,针对生命末期的患者.
- 目前的合规率很低,75-80%的绝症患者不遵守法律.
- 在区分"终端阶段"和"染过程"方面存在模糊性,需要统一的定义.
研究的目的:
- 分析LST法案在前三年出现的问题.
- 提出改进措施,以解决缺陷并加强患者的自决能力.
- 确保在维持生命的治疗决策中保护患者的最佳利益.
主要方法:
- 对LST法案的法律框架和实际实施进行分析.
- 对患者病例和与生命末期决策相关的医疗记录的审查.
- 法律定义和程序要求的比较研究.
主要成果:
- 合规性较低表明,该法案的实施面临重大挑战.
- 法律定义的混乱和程序的复杂性阻碍了有效的实施.
- 患者的愿望和自主性并不总是反映在当前的实践中.
结论:
- "终端阶段"和"染过程"应该统一成一个单一的"终端阶段"定义.
- 扩大符合条件的医疗机构,并允许医院伦理委员会为缺乏家庭支持的患者做出决定.
- 通过取代特定信件的医疗记录和整合表格来简化文档,以改善遵守和尊重患者自主权.
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