探索中国对意识障碍的终身决策
Meiqi Li1,2, Benedetta Cecconi3,4, Olivia Gosseries3,4
1International Unresponsive Wakefulness Syndrome and Consciousness Science Institute, Hangzhou Normal University, Hangzhou, China.
Annals of medicine
|November 26, 2024
概括
中国参与者对有意识障碍 (DoC) 的患者停止维持生命治疗 (WLST) 的接受度较低. 个人因素会影响人们的态度,这凸显出需要对决策制定更明确的法规.
科学领域:
- 医学伦理 医学伦理
- 神经学 神经学
- 公共卫生 公共卫生
背景情况:
- 意识障碍 (DoC) 对维持生命治疗提出了复杂的伦理挑战.
- 取消维持生命治疗 (WLST) 的决定需要了解社会态度,特别是在多样化的人口中.
- 在中国,对DoC患者的伦理考虑研究不足,需要对公众和专业观点进行调查.
研究的目的:
- 调查中国人口对WLST在DoC患者中的伦理态度.
- 确定影响医疗专业人员和普通公众这些态度的因素.
- 为在DoC中替代决策制定指南的制定提供信息.
主要方法:
- 在2022年2月至7月期间,向1223名中国参与者 (包括医疗专业人员) 分发了一份关于WLST的自我管理问卷.
- 使用统计分析,包括千平方测试和后勤回归来检查数据.
- 收集了参与者的人口统计信息和关于停止人工营养和水分 (ANH),抗生素和不复苏 (DNR) 命令的意见.
主要成果:
- 不到三分之一的参与者对不响应的清醒综合征 (UWS) 和最小意识状态 (MCS) 患者的WLST持积极态度.
- 态度有显著差异,与MCS相比,在UWS中WLST的接受度更高 (p <0.05).
- 对DNR订单的积极态度与年龄较大,宗教信仰,收入较高和医疗专业相关 (p < 0.05). 患者的遗嘱,家庭的愿望和经济负担是关键考虑因素.
结论:
- 中国的受访者表明,对医疗中心患者来说,WLST的接受度相对较低.
- 个体特征显著影响着对WLST的伦理态度.
- 需要改进法规,以确定合格的代孕决策者,并减少DoC治疗中断的法律模两可.
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