对晚期痴呆症进行有效的临终干预可以被视为道德行为吗?

IF 4 Q1 CLINICAL NEUROLOGY
Stanley A Terman
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引用次数: 0

摘要

许多人都害怕在临终疾病--晚期痴呆症--的折磨中度过漫长的死亡。为了成功地促进及时死亡,预先指令必须是有效和可接受的。本文探讨了包括主治医生在内的权威人士是否可以接受停止护理人员协助口服喂食和水化的有效干预是合乎道德的。文章提出了关于停止辅助喂食/补充水分的八种批评和 "另一种观点"。文章借鉴了临床医学、法律、伦理学和宗教的观点。冲突发生在 (A) 人们的核心信仰与 (B) 病人的自主自决权和避免痛苦的权利之间,前者反映了关于什么是道德的文化规范和宗教教义。文章尽可能有力地阐述了双方的观点。接受干预是合乎道德的,可以让患者安详、及时地从潜在疾病中死去。对未来成功的信心会阻止患者及其代理人在痴呆症早期阶段考虑加速死亡。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Can an effective end-of-life intervention for advanced dementia be viewed as moral?

Many people dread prolonged dying with suffering in the terminal illness, advanced dementia. To successfully facilitate a timely dying, advance directives must be effective and acceptable. This article considers whether authorities, including treating physicians, can accept as moral, the effective intervention that ceases caregivers' assistance with oral feeding and hydrating. The article presents eight criticisms and "alternate views" regarding ceasing assisted feeding/hydrating. It draws on perspectives from clinical medicine, law, ethics, and religion. The conflict is between (A) people's core beliefs that reflect cultural norms and religious teachings regarding what is moral versus (B) patients' autonomous right of self-determination and claim right to avoid suffering. The article presents each side as strongly as possible. Accepting the intervention as moral could allow patients a peaceful and timely dying from patients' underlying disease. Confidence in future success can deter patients and their surrogates from considering a hastened dying in earlier stages of dementia.

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来源期刊
CiteScore
7.80
自引率
7.50%
发文量
101
审稿时长
8 weeks
期刊介绍: Alzheimer''s & Dementia: Diagnosis, Assessment & Disease Monitoring (DADM) is an open access, peer-reviewed, journal from the Alzheimer''s Association® that will publish new research that reports the discovery, development and validation of instruments, technologies, algorithms, and innovative processes. Papers will cover a range of topics interested in the early and accurate detection of individuals with memory complaints and/or among asymptomatic individuals at elevated risk for various forms of memory disorders. The expectation for published papers will be to translate fundamental knowledge about the neurobiology of the disease into practical reports that describe both the conceptual and methodological aspects of the submitted scientific inquiry. Published topics will explore the development of biomarkers, surrogate markers, and conceptual/methodological challenges. Publication priority will be given to papers that 1) describe putative surrogate markers that accurately track disease progression, 2) biomarkers that fulfill international regulatory requirements, 3) reports from large, well-characterized population-based cohorts that comprise the heterogeneity and diversity of asymptomatic individuals and 4) algorithmic development that considers multi-marker arrays (e.g., integrated-omics, genetics, biofluids, imaging, etc.) and advanced computational analytics and technologies.
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