[从伦理角度确定重症监护的优先次序]。

Lakartidningen Pub Date : 2024-09-18
Niklas Juth, Eva Hannerz Schmidtke
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引用次数: 0

摘要

重症监护病房的优先顺序是根据所谓的伦理纲领依法确定的,该纲领规定,所有优先顺序都必须基于三项按词义排序的原则:人类尊严原则(禁止歧视,例如基于社会地位的歧视)、需求和团结原则以及成本效益原则。确定重症监护的优先次序尤其困难,因为这需要对不同类别的病人进行比较,而且是在危急情况下进行,预后也充满了极大的不确定性。有时,一些病人的病情已达到最严重的程度:如果不进行治疗,他们就会死亡。这时,治疗效果和成本效益对决定优先次序就更具有决定性意义。此外,越来越多的人认为暂停和撤销重症监护在道义上是等同的。艰难的优先顺序决定有可能给重症监护人员带来道德压力。
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[Priority setting in intensive care from an ethical perspective].

Priority setting at intensive care units is legally regulated in accordance with the so-called ethical platform, which states that all priorities must be based on three lexically ranked principles: the principle of human dignity (a ban on discrimination, e.g. based on social standing), the principle of needs and solidarity, and the principle of cost-effectiveness. Prioritization for intensive care is particularly difficult as it requires comparisons between widely different patient categories, occurs in acute situations and is fraught with great uncertainty about the prognosis. Sometimes the degree of severity is maximal for several patients: without treatment, they die. Then treatment effect and cost-effectiveness become more decisive for prioritization decisions. Moreover, withholding and withdrawing intensive care are increasingly considered as morally equivalent. Difficult priority decisions risk moral stress among the intensive care staff.

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来源期刊
Lakartidningen
Lakartidningen Medicine-Medicine (all)
CiteScore
0.30
自引率
0.00%
发文量
134
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