缓和医疗中的伦理学问题  

Ethical Issues in Palliative Care

作　　者：张迪[1,2] 毕可嘉 徐士婷 ZHANG Di;BI Kejia;XU Shiting(School of Humanities and Social Sciences,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China;Center for Bioethics,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China;School of Nursing,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China)

机构地区：[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学院护理学院,北京100730

出　　处：《协和医学杂志》2024年第1期24-31,共8页Medical Journal of Peking Union Medical College Hospital

基　　金：北京协和医学院2023年中央高校教育教学改革专项资金支持项目(2023zlgl056)。

摘　　要：随着医疗理念的更新,缓和医疗已成为生命终末期患者照护的重要组成部分,与此同时,其所涉及的伦理学问题日益凸显。本文通过综述国内外缓和医疗伦理学相关研究,旨在梳理缓和医疗中5个关键的伦理学问题,包括讲真话、预立照护计划、维生干预的使用、缓和镇静、安乐死和协助死亡与缓和医疗的关系,为缓和医疗实践提供了伦理学视角,以期帮助从事缓和医疗的专业人员加深认知,更好地为患者及其家属提供高质量照护,同时为相关法律法规和政策的制定提供参考。With the transformation of medical philosophy,palliative care has become a fundamental component of end-of-life care for patients with life-threatening illnesses,meanwhile ethical issues involved in palliative care are becoming more prominent.This article,through a comprehensive review of both domestic and international ethical research,articulates five crucial ethical issues inherent to palliative care:truth-telling,advance care planning,the use of life-sustaining interventions,palliative sedation,and the relationship between euthanasia,assisted dying,and palliative care.The objective is to offer an ethical perspective for palliative care,help professionals in palliative care to address the critical ethical issues in practice,improve the quality of care for patients and their families,and to inform the development of related legal,regulatory,and policy frameworks.

关 键 词：缓和医疗 伦理 维生干预 缓和镇静 生前预嘱 

分 类 号：R48[医药卫生—临床医学]