在生命结束时关闭左心室辅助设备:叙述审查和道德框架
Danish Zaidi1, James N Kirkpatrick2, Savitri E Fedson3
1Department of Medicine, Yale School of Medicine, New Haven, Connecticut, USA.
JACC. Heart failure
|September 28, 2023
概括
左心室辅助器件 (LVAD) 延长了严重心力衰竭患者的寿命,这引发了关于设备停用的复杂伦理问题. 了解LVAD和伦理框架对于以患者为中心的护理至关重要.
科学领域:
- 心脏病学 心脏病学
- 医学伦理 医学伦理
- 生物伦理学生物伦理学
背景情况:
- 左心室辅助装置 (LVAD) 是治疗严重心力衰竭的先进疗法.
- LVAD引发了关于患者身份,价值观和治疗分类的伦理问题.
- 要求关闭LVAD的要求需要仔细的伦理考虑.
研究的目的:
- 为临床医生提供对LVAD和停用伦理的更深入的理解.
- 探索LVAD禁用的历史,性质和伦理背景.
- 引入一个框架来处理LVAD禁用请求,特别是在复杂的情况下.
主要方法:
- 关于LVAD和设备停用伦理的文献综述.
- 对LVAD患者终身护理中的伦理考虑的分析.
- 制定预先护理规划和息护理整合框架.
主要成果:
- 由于其延长生命的性质,LVADs存在独特的伦理挑战.
- 对LVAD停用进行道德决策需要了解设备特点和患者价值.
- 提前护理规划和息护理整合是尊重患者自主权的关键.
结论:
- 在LVAD植入之前,明确的预先护理计划是必不可少的.
- 建议早期和持续整合临终关怀和息医学专家.
- 需要进一步研究患者和临床医生对LVAD停用的态度.
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