Withdrawing artificial nutrition and hydration from minimally conscious and vegetative patients: family perspectives
Withdrawing artificial nutrition and hydration from minimally conscious and vegetative patients: family perspectives
复制标题
从意识不清和植物人患者身上撤走人工营养和水分：家属的观点
DOI：
10.1136/medethics-2013-101799
复制
发表时间：
2015-02-01
影响因子：
4.1
通讯作者：
Kitzinger, Jenny
中科院分区：
文献类型：
--
作者：
Kitzinger, Celia;Kitzinger, Jenny
在W诉M一案中，家庭成员向保护法院提出申请，要求从一名意识最低的病人身上收回人工营养和水合作用。随后的学术讨论集中在法官决定不授权撤回的道德充分性上。本文带来了一个不同的视角，通过对51个人的采访，他们的亲属是（或曾经是）植物人或最低意识状态（MCS）。大多数专业的医学伦理学家都把这个问题视为生与死的问题;相反，家庭--包括那些认为他们的亲属不想活下去的人--关注的是拟议的死亡方式，并且经常对“饥饿和脱水”导致死亡的想法感到恐惧。这种做法的实际后果可能是，处于永久植物人状态（PVS）和MCS的人在他们的家人相信病人宁愿死很久之后，仍然接受延长生命的治疗。我们建议，医学伦理学家关心的权利，人们在PVS/MCS需要考虑到这一经验数据，在寻求应用伦理理论的医学法律现实。
In W v M, family members made an application to the Court of Protection for withdrawal of artificial nutrition and hydration from a minimally conscious patient. Subsequent scholarly discussion has centred around the ethical adequacy of the judge's decision not to authorise withdrawal. This article brings a different perspective by drawing on interviews with 51 individuals with a relative who is (or was) in a vegetative or minimally conscious state (MCS). Most professional medical ethicists have treated the issue as one of life versus death; by contrast, families-including those who believed that their relative would not have wanted to be kept alive-focused on the manner of the proposed death and were often horrified at the idea of causing death by 'starvation and dehydration'. The practical consequence of this can be that people in permanent vegetative state (PVS) and MCS are being administered life-prolonging treatments long after their families have come to believe that the patient would rather be dead. We suggest that medical ethicists concerned about the rights of people in PVS/MCS need to take this empirical data into account in seeking to apply ethical theories to medico-legal realities.