[在ICU中停止维持生命的治疗 - - 不同的医生采取不同的行动]
Brian Cleaver1, Karin Hildebrand2, Maria Cronhjort3
1överläkare, donationsansvarig läkare, VO anestesi/Iva, Södersjukhuset, Stockholm.
Lakartidningen
|June 4, 2024
概括
集中治疗室医生表现出不同的方法来取消维持生命的治疗,影响员工和家人. 经验较少的医生可能会通过断奶延长死亡,强调需要进行标准化的终身护理讨论.
科学领域:
- 医学伦理 医学伦理
- 密集护理医学 密集护理医学
- 临床决策 - 临床决策
背景情况:
- 在重症监护室 (ICU) 中,经常会停止维持生命的治疗.
- 现有的研究显示,医生如何取消治疗的方法存在显著的变化.
- 这种不一致性可能会引起ICU工作人员和患者亲属的压力.
研究的目的:
- 调查瑞典ICU医生关于停止治疗的决策过程.
- 为了识别假设患者的药物和呼吸器支持的撤回变化.
主要方法:
- 一项试点研究检查了瑞典ICU医生关于停止维持生命治疗的决定.
- 利用两个虚构的患者场景来评估各种临床判断.
- 分析了关于药物和呼吸器支持撤销的决定.
主要成果:
- 在决定停止治疗和使用的方法中观察到相当大的差异.
- 在如何管理药物治疗和呼吸系统支持方面发现了差异.
- 经验较少的医生更倾向于通过断奶延长死亡过程.
结论:
- 医生的经验水平会影响对终身护理和终止治疗的决定.
- 退出惯例的变化可能与员工或家庭的偏好不一致.
- 研究结果可以为ICU讨论提供信息,以标准化和改进终身护理决策.
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