Medically Futile Care: The Role of the Physician in Setting Limits
Medically Futile Care: The Role of the Physician in Setting Limits
复制标题
医疗上无用的护理：医生在设定限制方面的作用
DOI：
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发表时间：
1992
影响因子：
0.6
通讯作者：
C. M. Spicer
中科院分区：
文献类型：
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作者：
R. Veatch;C. M. Spicer
为了澄清“医疗无效护理”的概念，无效护理分为两种类型：1）没有产生明显效果的护理； 2) 所产生的效果被说话人认为没有净收益的护理。这是第二种类型的无效护理，即当患者或代理人和临床医生对患者将从干预中获得的益处存在分歧时，这在道德上是最有趣的，并且不能正确地被贴上医学上无效的标签。因此，限制获得医疗服务的决定被认为是徒劳的，不应由医疗专业人员来决定。本文主张临床医生有有限责任提供延长生命和其他一些基本护理，这些护理在有能力的情况下得到公平资助并得到患者的期望，即使临床医生认为此类干预措施不会产生净效益。
In an effort to clarify the concept of “medically futile care,” two types of futile care are identified: 1) care that produces no demonstrable effect; and 2) care that produces an effect that is believed by the speaker to be of no net benefit. It is the second type of futile care, when a patient or surrogate and the clinician disagree over the benefit that the patient will receive from an intervention, that is most interesting morally and that cannot properly be labelled medically futile. As such, decisions to limit access to care deemed futile should not rest with medical professionals. This Article argues for a limited duty of clinicians to provide life-prolonging and some other fundamental care that is equitably funded and desired by the patient while competent, even if the clinician believes that such interventions will produce no net benefit.