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撤除生命维持干预的伦理学辩护

张迪,  宁晓红

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张迪, 宁晓红. 撤除生命维持干预的伦理学辩护[J]. 协和医学杂志. doi: 10.12290/xhyxzz.2022-0332
引用本文: 张迪, 宁晓红. 撤除生命维持干预的伦理学辩护[J]. 协和医学杂志. doi: 10.12290/xhyxzz.2022-0332
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ZHANG Di, NING Xiaohong. Ethical Arguments for Withdrawing Life-sustaining Medical Intervention[J]. Medical Journal of Peking Union Medical College Hospital. doi: 10.12290/xhyxzz.2022-0332
Citation: ZHANG Di, NING Xiaohong. Ethical Arguments for Withdrawing Life-sustaining Medical Intervention[J]. Medical Journal of Peking Union Medical College Hospital. doi: 10.12290/xhyxzz.2022-0332
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撤除生命维持干预的伦理学辩护

doi: 10.12290/xhyxzz.2022-0332

  • 1 中国医学科学院北京协和医学院人文和社会科学学院, 北京 100730;

  • 2 中国医学科学院北京协和医学院生命伦理学研究中心, 北京 100730;

  • 3 中国医学科学院北京协和医院老年医学科, 北京 100730

基金项目: 

中国医学科学院北京协和医学院教学改革项目（2019zlgc0119）

详细信息
    通讯作者:

    宁晓红，E-mail：ningxh1973@foxmail.com

  • 中图分类号: R-052

Ethical Arguments for Withdrawing Life-sustaining Medical Intervention

  • 1 School of Humanities and Social Sciences, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China;

  • 2 Center for Bioethics, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China;

  • 3 Department of Gerontology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China

Funds: 

The Education Reform Projects of Chinese Academic of Medical Sciences & Peking Union Medical College（2019zlgc0119）

    摘要
  • 摘要: 撤除生命维持干预（life-sustaining medical intervention，LSMI）是临床实践中常见的伦理学问题。本文分别从尊重患者自主性、无效医疗和患者最佳利益三个方面，尝试对撤除LSMI的伦理学可辩护性进行梳理和分析，并结合案例为临床实践中撤除LSMI提出可操作性建议及对策。笔者认为符合下述任一条件时，撤除LSMI可得到伦理学辩护：（1）患者给出有效同意；（2）生命维持干预被判定为无效医疗；（3）撤除生命维持干预符合患者的最佳利益。最后，笔者指出实践中撤除LSMI所面临的挑战及可能的解决途径。
    Abstract: Decision to withdrawal of life-sustaining medical interventions(LSMI) is a common ethical issue in clinical practice. This paper review and analyze the ethical arguments for withdrawing LSMI from three aspects:respect for autonomy, medical futility, and patients' best interests. The authors argue that withdrawal of LSMI can be ethically justified when any of the following conditions are met:when patient gives valid consent, LSMI is judged to be medical futility, or in the patients' best interests. This paper proposes practical suggestions for the withdrawal of LSMI in clinical practice, and presents several policy suggestions. Finally, the authors identified several challenges of withdrawing LSMI in practice and possible pathways to address them.
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    • 参考文献(26)
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出版历程
  • 收稿日期:  2022-06-15
  • 录用日期:  2022-08-30
  • 网络出版日期:  2022-09-23

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