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臺灣無效醫療現況與臺北榮民總醫院無效醫療判定經驗分享

Abstracts


美國醫學會(American Medical Association, AMA)1999年指出當重症患者的照護措施僅能延長末期病人的死亡過程即稱為無效醫療。自民國89年及105年制定了《安寧緩和醫療條例》與《病人自主權利法》起,雖用以保障病人的自主權益,避免發生無效醫療的情形,但在重症醫療單位例如加護病房,卻仍舊存在著許多無效醫療的例子,實為目前制度下一直廣受爭議的議題。本文目的是簡介臺灣重症醫學無效醫療的現況,並以臺北榮民總醫院重症病房為例,作為無效醫療判定的分享。

References


American Medical Associations. Medical futility in end of life care: report of the Council on Ethical and Judicial Affairs. JAMA 1999;281:937-41.
Bosslet GT, Pope TM, Rubenfeld GD, et al. An official ATS/AACN/ ACCP/ESICM/SCCM policy statement: responding to requests for potentially inappropriate treatments in intensive care units. Am J Respir Crit Care Med 2015;191:1318-30.
White B, Willmott L, Close E, et al. What does "futility" mean? An empirical study of doctors' perceptions. Med J Aust 2016;204:318.
Kasman DL. When is medical treatment futile? A guide for students, residents, and physicians. J Gen Intern Med 2004;19:1053-6.
Carter HE, Winch S, Barnett AG, et al. Incidence, duration and cost of futile treatment in end-of-life hospital admissions to three Australian public-sector tertiary hospitals: a retrospective multicentre cohort study. BMJ Open 2017;7:e017661.

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