隨著醫藥科技不斷的進步,急重症加護技術的發展,使得重症病患的生命得以延長。愈來愈多的重症病人可能在加護病房進入生命末期階段。而醫療人員在加護病房裡經常需面對生命末期的病患,當病患疾病進展至死亡已不可避免時,醫療人員與家屬都會面臨所施予的維生措施是否有效或只是延長病人死亡的過程之質疑。如果是後者,這所謂的無效醫療所影響的不僅是龐大的健保費用、加護病房有限床位使用的適當性及生命倫理的困境外,甚者更可能造成病人無法較舒適的善終。本文之目的即探討醫院裡重症加護病房執行無效醫療的原因,並說如何避免無效醫療的情況提出建議措施,期透過臨床醫護人員的努力,提供生命末期病患及家屬適切的照護,以達病人善終、家屬無憾、醫者安心的目標。
It is common to face patients' end-of-life (EOL) issue in the intensive care units (ICU). When death is inevitable, the life-support therapies provided is futile at times, prolonging the dying process. The medical futility may raise the problems such as the huge cost of social resources, and consumption of medical resources. Most of all, medical futility eliminates the possibility of ”good death”. The purpose of this article is to investigate the cause of the medical futility in ICU EOL care. Furthermore, palliative care is recommended to avoid medical futility, in order to reach the goals including: (1) The patients can have the process of respectful death. (2) The family can make the proper decisions without regrets. (3) The healthcare givers are in peace.
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