Grasping the nettle - what to do when patients withdraw their consent for treatment: (a clinical perspective on the case of Ms B)
Grasping the nettle - what to do when patients withdraw their consent for treatment: (a clinical perspective on the case of Ms B)
复制标题
DOI：
10.1136/jme.28.4.236
复制
发表时间：
2002-08-01
影响因子：
4.1
通讯作者：
Tweeddale, MG
中科院分区：
文献类型：
--
作者：
Tweeddale, MG
撤回积极治疗在医疗实践中很常见，特别是在重症监护医学中。然而，它通常涉及无法参与决策过程的患者。正如B女士的案例所表明的那样，当病人醒着并要求采取这样的行动时，医生有时不愿意撤回积极的治疗。从理论上讲，有一个有能力的病人应该有助于临床决策，那么问题出在哪里呢？当病人要求医生采取与自己的观点相冲突的行动时，潜在的医疗家长主义可能会浮出水面。
Withdrawal of active treatment is common in medical practice, especially in critical care medicine. Usually, however, it involves patients who are unable to take part in the decision making process. As the case of Ms B shows, doctors are sometimes reluctant to withdraw active treatment when the patient is awake and requesting such a course of action. In theory, having a competent patient should facilitate clinical decision making, so where does the problem arise? It is argued that latent medical paternalism may come to the surface when doctors are asked by patients to follow a course of action which is in conflict with their own perspective.