缓解性全身麻醉在终端输出管: "温柔地进入那个美好的夜晚"
1Section of Neurocritical Care, Departments of Neurology and Neurosurgery, MacLean Center for Clinical Medical Ethics, University of Chicago, Chicago, IL, USA. lazaridis@uchicagomedicine.org.
Neurocritical care
|March 3, 2025
概括
终端输出管可能会导致痛苦. 建议使用息全身麻醉,以防止在停止机械通风时患者遭受痛苦,防止潜在的伤害.
科学领域:
- 医学伦理 医学伦理
- 密集护理医学 密集护理医学
- 抚慰性护理是一种缓解性护理.
背景情况:
- 在重症监护室中,停止机械通风或终端输出管是常见的.
- 目前的做法使用止痛和镇静,旨在缓解痛苦而不加快死亡.
- 目前的镇静实践的有效性和患者体验没有得到充分的监测.
研究的目的:
- 论证在终端输出管过程中使用息性全身麻醉.
- 为了解决人们对患者痛苦和隐藏意识的担忧.
- 挑战基于对危害的哲学概念的现行做法.
主要方法:
- 对伤害和息性麻醉的哲学分析.
- 对隐藏意识和认知运动分离的证据的审查.
- 检查当前终身护理实践背后的假设.
主要成果:
- 目前的做法依赖于关于患者意识和监测的可疑假设.
- 息性全麻醉可以保护患者在输出管过程中免受潜在的痛苦.
- 在这种情况下",首先,不要伤害"的原则支持全身麻醉.
结论:
- 缓解性全身麻醉提供了更强大的保障,防止在终端输出管过程中遭受痛苦.
- 这种方法挑战了当前的做法,而不参与安乐死辩论.
- 这项研究倡导重新评估重症监护机构的生命终端护理协议.
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