Response to "Added Points of Concern About Caring for Dying Patients".
Response to "Added Points of Concern About Caring for Dying Patients".
复制标题
对“关于照顾临终患者的新增关注点”的回应。
DOI：
10.1001/amajethics.2018.1110
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发表时间：
2018
影响因子：
--
通讯作者：
Dzeng,Elizabeth
中科院分区：
文献类型：
--
作者：
Craig,Alexander;Dzeng,Elizabeth
不幸的是，这封信的作者认为S博士对法律的仔细审查是为了避免责任，而不是为了保护唐纳德的最大利益。我们同样可以声称，S博士试图操纵法律，为他认为应该符合条件的病人提供医生死亡援助（PAD）。我们同意，这些作者提出的框架似乎是自私的，但没有理由假设这是S博士的主要动机。当然，S博士的动机应该被考虑和评估，但我们认为这不是案件的核心特征。案件具体提出的问题不是人民民主联盟在伦理、道德或法律上是否合理，尽管这肯定是一个值得另一个论坛讨论的问题。相反，问题在于，同意PAD可以接受的医生是否同意为缺乏身体能力来履行法律明确规定的患者提供PAD，这符合伦理道德。尽管S博士对PAD的个人观点，我们强调，医生是否决定根据PAD法律处方致命药物是一个非常个人和道德的决定。拒绝PAD可能会损害医患关系和护理的连续性，并导致潜在的被遗弃感，正如我们的论文中所描述的那样，这些伤害既重要又难以量化。Dale对加州大学董事会、加州大学旧金山分校弗朗西斯科（UCSF）健康部和其他被告的诉讼就是一个例子，在这个例子中，病人和家属因医生拒绝提供PAD而感到受到极大的伤害。[1]事实上，在PAD在加州法律的实施的短时间内，患者因无法找到处方医生而产生的压力和困惑是一个不常见的挑战。
It is unfortunate that this letter’s authors perceive Dr S’s careful scrutiny of the laws to be motivated by avoiding liability instead of by protecting Donald’s best interests. We could equally claim that Dr S is attempting to navigate the law in order to provide physician aid in dying (PAD) for a patient whom he thinks should be eligible. We agree that the framing presented by these authors appears self-serving, but there is no reason to assume this is Dr S’s primary motivation. Certainly, Dr S’s motives should be considered and evaluated, but we suggest they are not a central feature of the case.The issue specifically raised by the case is not whether PAD is ethically, morally, or legally justifiable, although this is certainly a worthy question for another forum. Rather, the issue is whether a physician who agrees that PAD can be acceptable acts ethically by agreeing to provide PAD for a patient who lacks the physical capacity to fulfill an explicit dictum of the law. Dr S’s personal views on PAD notwithstanding, we stress that whether a physician decides to prescribe lethal drugs under PAD laws is a deeply personal and moral decision. Refusing PAD could damage the physician-patient relationship and continuity of care, as well as contribute to potential feelings of abandonment, as described in our paper—harms that are as important to account for as they are difficult to quantify empirically. The Dale lawsuit against the University of California Board of Regents, University of California, San Francisco (UCSF) Health, and other defendants is one example in which a patient and family felt egregiously harmed by the physician’s refusal to provide PAD. 1 Indeed, patients’ stress and confusion as a result of their inability to find a prescribing physician represents a challenge not infrequently encountered during the short time that PAD has been legal in California.
影响因子：
158.5
作者：
Ganzini, L;Nelson, HD;Lee, MA
通讯作者：
Lee, MA