慢代码是唯一具有欺骗性的吗?
Michael B Grosso1, Paola Nicolas2,3
1Northwell Health, Division of Medical Ethics, The Donald and Barbara School of Medicine at Hofstra/Northwell, Hemstead, New York, USA.
Bioethics
|April 2, 2025
概括
慢代码,或"假代码",是不旨在恢复自发循环 (ROSC) 的复苏努力. 虽然在某些情况下道德上是不可接受的,但在其他情况下,他们的道德仍然存在争议,突出了复杂的生命终端护理道德.
科学领域:
- 医学伦理 医学伦理
- 临床实践 临床实践
- 在生命末期的护理.
背景情况:
- "骗局代码"或"缓慢代码"涉及进行复苏的努力,以显得彻底而不是实现ROSC.
- 这些做法已经被广泛谴责了50多年.
- 想要拒绝心肺复苏 (CPR) 的医生和希望它的家庭之间出现了冲突.
研究的目的:
- 检查慢代码的伦理允许性.
- 在涉及CPR决策的四个冲突场景中分析临床医生的义务.
- 探索与CPR相关的冲突的替代方案,并提出改革方案.
主要方法:
- 对涉及心肺复苏的四个不同的临床场景进行道德分析.
- 检查临床医生的道德义务和特权.
- 慢代码与替代性寿命终止实践的比较.
主要成果:
- 当生活质量或定量徒劳性是主要关注点时,慢代码被认为是不符合伦理的.
- 在其他场景中对慢代码的道德允许性采取了不可知论立场.
- 诸如不启动心肺复苏和有限心肺复苏试验等替代方案涉及类似的非虚假欺骗,出于有益的原因.
结论:
- 慢代码的伦理格局很复杂,允许性因临床环境而异.
- 缓慢代码的替代品有着共同的伦理考虑,包括欺骗.
- 建议进行改革,以防止冲突,并建立对终身护理决策的信任.
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