Shades of blue: the negotiation of limited codes by medical residents.
Shades of blue: the negotiation of limited codes by medical residents.
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蓝色阴影：住院医生对有限规范的谈判。
DOI：
10.1016/0277-9536(92)90257-q
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发表时间：
1992
期刊：
影响因子：
--
通讯作者：
Muller,JH
中科院分区：
文献类型：
--
作者：
Muller,JH
在当代医疗实践中，医生面临的最困难的决定之一是是否为危重患者启动或停止心肺复苏（CPR）。由于围绕这些决定的问题，医院最近制定了适当使用不复苏（DNR）命令的指南。尽管制定了这些准则，但在适用DNR命令方面仍然存在问题。本研究探讨了内科住院医师使用的一种策略，以科普复苏决策的问题性质-使用部分或缓慢的复苏尝试，被称为“有限代码”。它分析了这些代码的努力如何发挥作用的背景下，居民的工作，使居民规避道德和实际的困境，他们的临床实践的情况。
One of the most difficult decisions facing physicians in contemporary medical practice is whether to initiate or withhold cardiopulmonary resuscitation (CPR) for patients who are critically ill. Because of the problems surrounding these decisions, hospital guidelines have recently been developed for the appropriate use of do-not-resuscitate (DNR) orders. Despite the establishment of these guidelines, problems with the application of DNR orders remain. This study examines one strategy used by internal medicine resident physicians to cope with the problematic nature of decisions regarding resuscitation—the use of partial or slow resuscitation attempts, known as ‘limited codes.’ It analyzes how these code efforts play a role within the context of resident work by enabling residents to circumvent ethical and practical dilemmas created by the circumtances of their clinical practice.