2017-03-14 01:32

在这篇文章中,我们研究的影响,从护理的角度来看,隐瞒和撤回治疗和检查所涉及的伦理问题。当治疗是绝对不可能的一定的维持生命的医疗治疗如心肺复苏、机械通气、营养和水分,透析、输血和抗生素可能会被撤回或拒绝(Derse,2005)。关于最近媒体关注的Terri Schiavo案已成功地突出了伦理、撤回和扣缴处理法律和社会问题。小西等人(2002)讨论伦理退出人工食物和液体从绝症患者带来了两难的生活问题和生命是否患者可以停止或撤销处理故意结束。从绝症患者中提取食物和液体是一个日益严重的伦理问题,同时也对患者、家庭和护士产生了影响。这项研究抽样了160名护士,他们完成了一份问卷,包括强制选择和开放式的问题和退出治疗的行为,支持护士只有两个特定的条件-如果病人要求,如果它减轻病人的他或她的痛苦。然而,人们普遍认为,医生的嘱咐,家人的要求,甚至病人年事已高,不能也不应扣缴或道德上的理由放弃治疗的行为。研究表明,除了直接的临床问题,道德,社会和文化因素似乎发挥了重要作用,在任何决定撤回或隐瞒治疗。在这篇文章中,我们讨论的影响,撤回治疗和护士在这方面的作用。我们还讨论了伦理、社会和法律问题涉及预治疗和护士提供临终关怀面临的挑战。


In this essay we examine the impact of withholding and withdrawal of treatment from a nursing perspective and examine the ethical issues involved. When a cure is absolutely impossible certain life sustaining medical treatments such as cardiopulmonary resuscitation, ventilation, nutrition and hydration, dialysis, transfusions, and antibiotics may have to be withdrawn or withheld (Derse, 2005). Recent media attention on the case of Terri Schiavo has successfully highlighted the ethical, legal and social issues of withdrawing and withholding treatment. Konishi et al (2002) discuss the ethics of withdrawing artificial food and fluid from terminally ill patients bringing in the dilemma on end of life issues and whether life of patients could be ended intentionally by stopping or withdrawing treatment. Withdrawal of food and fluid from terminally ill patients is a growing ethical issue and concerns patients, families, and nurses as well. The study sampled 160 nurses and they completed a questionnaire that included forced-choice and open-ended questions and the act of withdrawing treatment was supported by nurses only for two specific conditions - if the patients requested it and if it relieved the patient of his or her suffering. However, it is widely agreed that doctors' orders, family's requests or even the patient's advanced age could not and should not ethically justify the act of withholding or withdrawing treatment. The study suggests that apart from the direct clinical issues concerned, the ethical, social and cultural factors seem to play a significant role in any decision of withdrawing or withholding treatment. In this essay we discuss the implications of withdrawing treatment and the role of nurses in this regard. We also discuss the ethical, social and legal issues involved in withholding treatment and the challenges faced by nurses providing end-of-life care.