双效镇静:当药物也可以减少特定症状时,医生是否不打算减少意识?
1Graduate School of Urban Social and Cultural Studies, Yokohama City University, Yokohama, Kanagawa, Japan harima@buffalo.edu arima@yokohama-cu.ac.jp.
息镇静的伦理是复杂的. 双效镇静 (DES) 使用药物来缓解症状和镇静,但医生通常打算减少意识,挑战道德理由.
科学领域:
- 医学伦理 医学伦理
- 抚慰性护理是一种缓解性护理.
- 药理学 药理学是指药理学的学科.
背景情况:
- 缓解性镇静在伦理上受到争议,特别是当镇静药物也可以缓解症状时.
- 像米达佐拉姆和吗啡这样的药物可以减少症状 (发作,疼痛,呼吸困难),同时也降低意识.
- 这种双重作用被称为双重效应镇静 (DES).
研究的目的:
- 检查围绕双效镇静剂 (DES) 的伦理要求.
- 调查 DES 中意识的减弱是否总是意想不到的副作用.
- 确定双重效应学说 (DDE) 是否可以在道德上证明 DES 的合理性.
主要方法:
- 对息镇静和双重效应学说的伦理论据的分析.
- 检查临床场景,其中镇静药物用于症状管理.
- 哲学调查医生在DES中的行为意向性.
主要成果:
- 声称在DES中减少意识只是副作用的说法往往是错误的.
- 医生经常打算在给予DES时减少意识.
- 预期或长期减少意识并不能自动使其成为副作用.
结论:
- 双重效应学说 (DDE) 可能不能证明DES的正当性,当意识的减少是有意的.
- DES,特别是当意识是一个预期的效果时,需要严格的道德评估.
- 这些病例应与没有缓解症状的镇静药物进行类似的评估.
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