继续使用可能不合适的维持生命的疗法:提供者观点
Rebekka DePew1, Kemberlee Bonnet2, David Schlundt2
1Department of Family Medicine (R.D.P.), Division of Supportive and Palliative Medicine, Emory University, Atlanta, GA, US.
Journal of pain and symptom management
|April 24, 2025
概括
儿科重症监护医生经常面临困境,当家庭要求维持生命的治疗被认为不合适时. 虽然大多数人会提供干预措施,但方法各不相同,强调需要机构支持和医生培训.
科学领域:
- 儿科重症监护医学 儿科重症监护医学
- 医学伦理 医学伦理
- 生物伦理学生物伦理学
背景情况:
- 关于医生在考虑拒绝或取消维持生命的疗法时采取的方法的数据有限,这与家庭的意愿相反.
- 之前的研究重点是当超过家庭反对扣留治疗时,医疗提供者的观点.
研究的目的:
- 了解儿科重症监护临床医生如何在家庭要求潜在不适当的维持生命治疗的情况下进行导航.
- 探索涉及儿科患者的复杂生命终端护理场景中的医生决策过程.
主要方法:
- 半结构化的小组采访与儿科重症监护教师.
- 为儿科重症医生制定一个全国性的,基于案例的道德困境调查.
- 对特定调查问题的回应分析,关于严重创伤性脑损伤后的持续支持.
主要成果:
- 大多数参与者表示他们将提供所要求的干预措施,但随后的行动存在显著差异.
- 医生们的目标是平衡避免长期痛苦与尊重父母的决策角色.
- 对一个涉及严重创伤性脑损伤和不良预后的儿童的病例的反应显示了不同的方法.
结论:
- 医生方法的变化凸显了这些道德困境的复杂性.
- 机构支持结构 (道德,法律,风险管理,息治疗) 是至关重要的.
- 需要加强对医生进行培训,实践和机构支持,以管理这些具有挑战性的以家庭为中心的决策.
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