抑郁症患者拒绝非精神病治疗:代理决策者应该如何代表患者的真实愿望?
Esther Berkowitz1, Stephen Trevick2
1Ascension Holy Family, 100 North River Rd, Des Plaines, IL, 60016, USA. esther.berkowitz@ascension.org.
概括
患有抑郁症的患者可能会拒绝维持生命的治疗,这引发了伦理方面的担忧. 一个"恢复性代表"模型有助于代理人尊重患者的真实自我,当当前的愿望似乎受到疾病的影响.
科学领域:
- 医学伦理 医学伦理
- 临床心理学 临床心理学
- 生物伦理学生物伦理学
背景情况:
- 精神疾病,特别是抑郁症,对于关于拒绝维持生命治疗的代理决策提出了伦理挑战.
- 当拒绝治疗与他们假定的真实自我相矛盾时,评估患者的能力变得复杂.
- 目前的代理人决策框架包括替代判断和最佳利益标准.
研究的目的:
- 介绍和检查该领域的研究成果.
- 恢复性代表性的恢复性代表性
- 在精神疾病患者拒绝治疗的情况下,代理决策的模型.
- 探索该模型如何帮助代孕产妇维护患者自主权,当由于疾病而导致的决定看起来不真实时.
主要方法:
- 一个未被诊断的抑郁症患者拒绝接受治疗的案例研究介绍.
- 替代决策挑战的伦理分析.
- 作为框架的修复性表示模型的建议.
主要成果:
- 这一案例凸显了当患者受到抑郁症的影响时,辨别其真实的愿望的困难.
- 恢复性代表模型为面临这种困境的代孕产妇提供了一个潜在的解决方案.
- 这种方法强调辨别患者的"最真实的自我",而不是当前的,受疾病影响的偏好.
结论:
- 恢复性表示模型为患有精神疾病的患者提供了对替代判断的细微方法.
- 这一框架可以帮助代孕产妇在道德上做出合理的决定,尊重患者的自主权.
- 需要进一步的研究,以指导临床医生和伦理学家应用这种模式.
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