预先指示在痴呆症患者食物和营养决策中的局限性。

IF 3.3 2区 哲学 Q1 ETHICS Journal of Medical Ethics Pub Date : 2024-10-22 DOI:10.1136/jme-2023-109652
Wayne Shelton, Cynthia Geppert
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引用次数: 0

摘要

对于希望在痴呆症晚期避免延长生命干预负担的有能力的人来说,预先指令至关重要。然而,本文将论证预先医疗指示在痴呆症临床病程中喂养患者问题上的应用应该比人们通常推测的要少。本文将在罗纳德-德沃金(Ronald Dworkin)和丽贝卡-德雷斯(Rebecca Dresser)关于先例自主权在决定个人未来临终关怀计划方面的道德权威的辩论中提出论点。我们将简要分析德沃金/德雷瑟辩论中的两篇重要文献所持的立场,并通过一个假设病人约翰(John)从诊断出痴呆症到死亡的整个过程,来说明预先指示应如何适用于其疾病发展过程中的关键点,尤其是与食物和营养相关的关键点。
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Limits of advance directives in decision-making around food and nutrition in patients with dementia.

Advance directives are critically important for capable individuals who wish to avoid the burdens of life-prolonging interventions in the advanced stages of dementia. However, this paper will argue that advance directives should have less application to questions about feeding patients during the clinical course of dementia than often has been presumed. The argument will be framed within the debate between Ronald Dworkin and Rebecca Dresser regarding the moral authority of precedent autonomy to determine an individual's future end-of-life care plan. We will use a brief analysis of the positions taken in two important papers that come out of the Dworkin/Dresser debate and a hypothetical patient, John, who will be followed from diagnosis of dementia to death, to show how advance directives should apply to key points in the progression of his disease, particularly in relation to food and nutrition.

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来源期刊
Journal of Medical Ethics
Journal of Medical Ethics 医学-医学:伦理
CiteScore
7.80
自引率
9.80%
发文量
164
审稿时长
4-8 weeks
期刊介绍: Journal of Medical Ethics is a leading international journal that reflects the whole field of medical ethics. The journal seeks to promote ethical reflection and conduct in scientific research and medical practice. It features articles on various ethical aspects of health care relevant to health care professionals, members of clinical ethics committees, medical ethics professionals, researchers and bioscientists, policy makers and patients. Subscribers to the Journal of Medical Ethics also receive Medical Humanities journal at no extra cost. JME is the official journal of the Institute of Medical Ethics.
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