一个病人不可调和的声音:考虑另一种类型的"拒绝"在烧伤护理
Anna D Goff1,2, Barrie J Huberman1,2
1Weill Cornell Medicine, New York, New York, United States.
概括
烧伤患者可能会因为焦虑或疼痛而拒绝护理,即使他们想活下去. 跨学科的方法对于管理这些复杂的治疗决策在烧伤幸存者至关重要.
科学领域:
- 烧伤护理 烧伤护理
- 临床伦理学 临床伦理学
- 患者的决策能力
背景情况:
- 文学往往侧重于决策能力和急性烧伤护理中的"死亡权".
- 提供者经常面临来自希望生存的患者的即时治疗拒绝.
- 拒绝的原因包括创伤反应,焦虑,疼痛和矛盾.
研究的目的:
- 探索超出急性决策能力的烧伤护理治疗拒绝的复杂性.
- 在此背景下,研究当前决策框架的实用性和局限性.
- 提出以患者为中心的,多学科的方法来管理此类案件.
主要方法:
- 案例研究灵感来自临床伦理学家与烧伤患者的经验.
- 对评估决策能力的现有框架的分析.
- 描述多学科团队对患者护理的方法.
主要成果:
- 标准的决策能力框架对于因痛苦而拒绝治疗的患者来说可能是不够的,而不是因为缺乏生活意愿.
- 以患者为中心的方法对于解决治疗回避的各种原因至关重要.
- 跨学科的合作可以提高对有复杂需求的烧伤患者的护理.
结论:
- 燃烧患者拒绝治疗的有效管理需要超出急性决策能力的细微理解.
- 一个以患者为中心的协作策略对于应对痛苦和促进生存至关重要.
- 对复杂的烧伤护理场景的伦理框架进行进一步的研究是有必要的.
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