3例ICU患者放弃治疗医患抉择异议的伦理思考  

Ethical Thinking on Three Cases of ICU Patients Giving Up Treatment and Opposing Choice between Doctor and Patient

作　　者：张小飞[1] 马菊华[2] 方志成[1] 刘伯毅[1] 刘菊英[3] ZHANG Xiao-fei;MA Ju-hua;FANG Zhi-cheng(Department of Critical Care Medicine,Taihe Hospital of Shiyan,Shiyan 442000,China)

机构地区：[1]十堰市太和医院重症医学科,湖北十堰442000 [2]湖北医药学院人文社会科学学院,湖北十堰442000 [3]十堰市太和医院麻醉科,湖北十堰442000

出　　处：《医学与哲学》2020年第12期20-22,共3页Medicine and Philosophy

基　　金：2016年湖北省教育厅人文社会科学重点项目(16D076);2018年湖北医药学院教学研究项目(2018016)。

摘　　要：ICU病房患者放弃治疗一直是医患双方争论的焦点,如何正确地对放弃治疗患者做出抉择显得格外重要。以3例ICU患者放弃治疗的实际案例为例,论述医患双方抉择的异议,进而深入剖析案例引发的伦理思考。从医务人员的角度探讨案例体现的过度医疗和无效医疗问题、终止治疗和放弃治疗问题以及对生命质量及价值的权衡,并提出强化疗效伦理意识、合理取舍放弃治疗时机、树立正确的生命观、增强对放弃治疗患者的临终关怀等解决对策,以期达到对ICU病房中危重患者救治更符合伦理要求的目的,为医患双方对ICU患者放弃治疗抉择提供伦理参考。Patients giving up treatment in ICU ward have always been a bone of contention between doctors and patients.Thus,it is particularly important to make the right decision for patients who gave up treatment.Taking the practical cases of 3 ICU patients who gave up treatments as the examples,this research discusses the opposing choice between doctor and patient,and then deeply analyzes the ethical thinking triggered by the cases.From the perspective of medical staff,this paper discusses the problems of excessive and futile medical treatment,the problems of discontinued and gave up treatment,and weighs the quality and value of life.It also proposes some solutions,such as strengthening the ethical consciousness of curative effect,making a choice about the time to give up treatment reasonably,cultivating a right outlooks on life,strengthening the hospice care for the patients who gave up treatment,etc.This paper aims to promote ethical treatment for critical patients in ICU ward,and provide ethical reference on choice of giving up treatment for both doctors and patients.

关 键 词：重症加强护理病房 临床伦理 医务人员 危重患者 

分 类 号：R-05[医药卫生]