意识障碍患者撤销生命维持治疗的伦理困境  

Ethical Dilemmas of Withdrawal of Life-sustaining Treatment for Patients with Disorders of Consciousness

作　　者：李美琦 孙玲秀 程丽娟[1] 李岩 Steven Laureys 狄海波[1] LI Mei-qi;SUN Ling-xiu;CHENG Li-juan(International Vegetative State and Consciousness Science Institute,Hangzhou Normal University,Hangzhou 311121,China)

机构地区：[1]杭州师范大学国际植物状态和意识科学研究所,浙江杭州311121 [2]比利时列日大学GIGA意识研究组昏迷科学团队,比利时列日4000

出　　处：《医学与哲学》2022年第22期22-25,共4页Medicine and Philosophy

基　　金：2019年国家自然科学基金重点国际(地区)合作研究项目(81920108023);2021年浙江省自然科学基金重点项目(Z21H170001)。

摘　　要：意识障碍领域中广泛存在着分类定义不清晰、诊断误诊率高、治疗缺乏有效性和康复不佳的临床问题。在意识障碍患者限制治疗的过程中,患者的最佳利益始终是一个未被讨论透彻的问题,西方医疗决策模式仍然存在一些缺陷且与我国存在显著差异。结合我国当下意识障碍患者医疗管理现状及医疗决策特点,提出可能的解决途径,如意识障碍患者多模态评估、分类管理、共同决策、预立照护计划。以期为意识障碍临床实践提供动力,并推进撤销意识障碍患者生命维持治疗的认识。There are widespread clinical problems in the field of disorders of consciousness(DOC) with unclearly defined categories, high rates of misdiagnosis, low effectiveness of treatment, and poor rehabilitation. The best interests of patients with DOC in the process of withdrawal of life-sustaining(WLST) treatment has not been comprehensively discussed yet, and the western medical decision-making model still has some flaws and significant differences from China. Combining the current state of medical management and medical decision-making characteristics of patients with DOC in China, possible solutions such as multimodal assessment, classification management, shared decision-making, and advanced care plans are proposed. The aim is to provide impetus for clinical practice and to advance the understanding of WLST for patients with DOC.

关 键 词：意识障碍 撤销治疗 伦理困境 

分 类 号：R-05[医药卫生]