疼痛和姑息治疗中的伦理问题。

IF 2.3 3区 医学 Q2 ANESTHESIOLOGY Current Opinion in Anesthesiology Pub Date : 2024-04-01 Epub Date: 2024-01-30 DOI:10.1097/ACO.0000000000001345
Marco Cascella, Alessandro Laudani, Giuliana Scarpati, Ornella Piazza
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引用次数: 0

摘要

回顾的目的:公众对疼痛和姑息治疗伦理问题的认识不断提高,再加上患者权益组织的支持,给医疗系统和专业人员带来了解决这些问题的压力。我们的目的是回顾与重症监护室姑息治疗有关的伦理困境、人工智能在疼痛治疗和姑息治疗中的应用以及阿片类药物的流行:在这篇重点综述中,我们重点介绍了过去 18 个月中发表的关于 ICU 中姑息治疗的伦理问题、人工智能发展轨迹以及阿片类药物流行如何影响疼痛管理实践的最新论文(见视觉摘要)。摘要:ICU 中的姑息治疗应由多学科团队参与,以减轻患者的痛苦和无用感。在重症监护室提供精神支持也是对患者进行整体护理的一个重要方面。越来越先进的疼痛诊断和治疗工具,如涉及人工智能的工具,可能会在使用上造成差异,引起知情同意问题,当然,它们需要谨慎和可重复性。全世界的疼痛临床医生仍然面临着为慢性非癌症疼痛患者开阿片类药物的道德困境。在有效缓解疼痛的需求与阿片类药物滥用、成瘾和过量风险之间取得平衡是一项极具争议的任务。
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Ethical issues in pain and palliation.

Purpose of review: Increased public awareness of ethical issues in pain and palliative care, along with patient advocacy groups, put pressure on healthcare systems and professionals to address these concerns.Our aim is to review the ethics dilemmas concerning palliative care in ICU, artificial intelligence applications in pain therapy and palliative care, and the opioids epidemics.

Recent findings: In this focus review, we highlighted state of the art papers that were published in the last 18 months, on ethical issues in palliative care within the ICU, artificial intelligence trajectories, and how opioids epidemics has impacted pain management practices (see Visual Abstract).

Summary: Palliative care in the ICU should involve a multidisciplinary team, to mitigate patients suffering and futility. Providing spiritual support in the ICU is an important aspect of holistic patient care too.Increasingly sophisticated tools for diagnosing and treating pain, as those involving artificial intelligence, might favour disparities in access, cause informed consent problems, and surely, they need prudence and reproducibility.Pain clinicians worldwide continue to face the ethical dilemma of prescribing opioids for patients with chronic noncancer pain. Balancing the need for effective pain relief with the risk of opioid misuse, addiction, and overdose is a very controversial task.

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来源期刊
CiteScore
4.90
自引率
8.00%
发文量
207
审稿时长
12 months
期刊介绍: ​​​​​​​​Published bimonthly and offering a unique and wide ranging perspective on the key developments in the field, each issue of Current Opinion in Anesthesiology features hand-picked review articles from our team of expert editors. With fifteen disciplines published across the year – including cardiovascular anesthesiology, neuroanesthesia and pain medicine – every issue also contains annotated references detailing the merits of the most important papers.
期刊最新文献
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