近几天，我天天泡在网上，就是翻查ICU的医生，在帮助病人做end of life decision的时候，参照的是什么标准。以下贴一篇我翻阅的文章摘录。并非想表明自己的倾向性。只是亲身体会过，确实深深感到，立场不同，角色不同，使得医生和病人(病人家属)，在定义best interests时，所得到的结论，可能完全不同。
Patients' and families' preferences for medical intensive care
M. Danis, D. L. Patrick, L. I. Southerland and M. L. Green
Department of Medicine, School of Medicine, University of North Carolina, Chapel Hill 27514.
Medical ethics suggest that life-sustaining treatment decisions should be made with consideration for patients' preferences and quality of life. Patients were interviewed who were at least 55 years old and had experienced medical intensive care at a university hospital during a one-year period to determine their preferences regarding intensive care; family members were interviewed if the patient had died (n = 160). Seventy percent of patients and families were 100% willing to undergo intensive care again to achieve even one month of survival; 8% were completely unwilling to undergo intensive care to achieve any prolongation of survival. Preferences were poorly correlated with functional status or quality of life and were not altered by life expectancy for 82% of respondents. Age, severity of critical illness, length of stay, and charges for intensive care did not influence willingness to undergo intensive care. These data suggest that personal preferences may conflict with any health policy that limits the allocation of intensive care based on age, function, or quality of life.
Patients' and families' preferences for medical intensive care
M. Danis, D. L. Patrick, L. I. Southerland and M. L. Green
Department of Medicine, School of Medicine, University of North Carolina, Chapel Hill 27514.
Medical ethics suggest that life-sustaining treatment decisions should be made with consideration for patients' preferences and quality of life. Patients were interviewed who were at least 55 years old and had experienced medical intensive care at a university hospital during a one-year period to determine their preferences regarding intensive care; family members were interviewed if the patient had died (n = 160). Seventy percent of patients and families were 100% willing to undergo intensive care again to achieve even one month of survival; 8% were completely unwilling to undergo intensive care to achieve any prolongation of survival. Preferences were poorly correlated with functional status or quality of life and were not altered by life expectancy for 82% of respondents. Age, severity of critical illness, length of stay, and charges for intensive care did not influence willingness to undergo intensive care. These data suggest that personal preferences may conflict with any health policy that limits the allocation of intensive care based on age, function, or quality of life.
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