{"title":"病人自主与干预:老年护理困境。","authors":"Zhongxi Gao","doi":"10.1177/23337214241276796","DOIUrl":null,"url":null,"abstract":"<p><p><b>Background:</b> The ethical challenges faced by physicians when patients or their families refuse medical interventions are particularly complex in geriatric care. This manuscript explores the delicate balance between professional recommendations and patient autonomy, focusing on the nuanced decisions surrounding enteral nutrition in older patients. <b>Methods:</b> Two case studies are presented: a 99-year-old woman with a history of hypertension, diabetes, and coronary heart disease, and an 82-year-old man with Alzheimer's disease. Both cases involve the recommendation of a nasogastric tube for enteral nutrition, and the subsequent patient and family responses to this intervention. <b>Results:</b> In the first case, the patient and her family initially refused the tube due to personal beliefs and financial concerns, leading to a focus on psychological support and symptom management. The patient eventually agreed to the tube, but tragically passed away shortly after. In contrast, the second case resulted in the patient's family agreeing to the tube after a thorough discussion, leading to a successful recovery and the patient's ability to eat orally 6 months later. <b>Conclusions:</b> The cases underscore the importance of patient-centered care, clear communication, and empathy in geriatric medicine. They highlight the need for healthcare providers to respect patient autonomy, be aware of their own biases, and engage in open dialogue with patients and families. The manuscript advocates for a nuanced approach to medical ethics, where the patient's journey is guided with respect and care, honoring their wishes while striving for the best possible outcomes.</p>","PeriodicalId":52146,"journal":{"name":"Gerontology and Geriatric Medicine","volume":"10 ","pages":"23337214241276796"},"PeriodicalIF":2.1000,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11348357/pdf/","citationCount":"0","resultStr":"{\"title\":\"Patient Autonomy Versus Intervention: Geriatric Care Dilemmas.\",\"authors\":\"Zhongxi Gao\",\"doi\":\"10.1177/23337214241276796\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p><b>Background:</b> The ethical challenges faced by physicians when patients or their families refuse medical interventions are particularly complex in geriatric care. This manuscript explores the delicate balance between professional recommendations and patient autonomy, focusing on the nuanced decisions surrounding enteral nutrition in older patients. <b>Methods:</b> Two case studies are presented: a 99-year-old woman with a history of hypertension, diabetes, and coronary heart disease, and an 82-year-old man with Alzheimer's disease. Both cases involve the recommendation of a nasogastric tube for enteral nutrition, and the subsequent patient and family responses to this intervention. <b>Results:</b> In the first case, the patient and her family initially refused the tube due to personal beliefs and financial concerns, leading to a focus on psychological support and symptom management. The patient eventually agreed to the tube, but tragically passed away shortly after. In contrast, the second case resulted in the patient's family agreeing to the tube after a thorough discussion, leading to a successful recovery and the patient's ability to eat orally 6 months later. <b>Conclusions:</b> The cases underscore the importance of patient-centered care, clear communication, and empathy in geriatric medicine. They highlight the need for healthcare providers to respect patient autonomy, be aware of their own biases, and engage in open dialogue with patients and families. The manuscript advocates for a nuanced approach to medical ethics, where the patient's journey is guided with respect and care, honoring their wishes while striving for the best possible outcomes.</p>\",\"PeriodicalId\":52146,\"journal\":{\"name\":\"Gerontology and Geriatric Medicine\",\"volume\":\"10 \",\"pages\":\"23337214241276796\"},\"PeriodicalIF\":2.1000,\"publicationDate\":\"2024-08-27\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11348357/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Gerontology and Geriatric Medicine\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1177/23337214241276796\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q3\",\"JCRName\":\"GERIATRICS & GERONTOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Gerontology and Geriatric Medicine","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1177/23337214241276796","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"GERIATRICS & GERONTOLOGY","Score":null,"Total":0}
Patient Autonomy Versus Intervention: Geriatric Care Dilemmas.
Background: The ethical challenges faced by physicians when patients or their families refuse medical interventions are particularly complex in geriatric care. This manuscript explores the delicate balance between professional recommendations and patient autonomy, focusing on the nuanced decisions surrounding enteral nutrition in older patients. Methods: Two case studies are presented: a 99-year-old woman with a history of hypertension, diabetes, and coronary heart disease, and an 82-year-old man with Alzheimer's disease. Both cases involve the recommendation of a nasogastric tube for enteral nutrition, and the subsequent patient and family responses to this intervention. Results: In the first case, the patient and her family initially refused the tube due to personal beliefs and financial concerns, leading to a focus on psychological support and symptom management. The patient eventually agreed to the tube, but tragically passed away shortly after. In contrast, the second case resulted in the patient's family agreeing to the tube after a thorough discussion, leading to a successful recovery and the patient's ability to eat orally 6 months later. Conclusions: The cases underscore the importance of patient-centered care, clear communication, and empathy in geriatric medicine. They highlight the need for healthcare providers to respect patient autonomy, be aware of their own biases, and engage in open dialogue with patients and families. The manuscript advocates for a nuanced approach to medical ethics, where the patient's journey is guided with respect and care, honoring their wishes while striving for the best possible outcomes.
期刊介绍:
Gerontology and Geriatric Medicine (GGM) is an interdisciplinary, peer-reviewed open access journal where scholars from a variety of disciplines present their work focusing on the psychological, behavioral, social, and biological aspects of aging, and public health services and research related to aging. The journal addresses a wide variety of topics related to health services research in gerontology and geriatrics. GGM seeks to be one of the world’s premier Open Access outlets for gerontological academic research. As such, GGM does not limit content due to page budgets or thematic significance. Papers will be subjected to rigorous peer review but will be selected solely on the basis of whether the research is sound and deserves publication. By virtue of not restricting papers to a narrow discipline, GGM facilitates the discovery of the connections between papers.