無效醫療議題之探討

儘管科技的進步使重症患者得以延長壽命，但醫療終究有其極限，某些情況下任憑再努力都是徒勞無功的情況時有所見，它使患者承受治療的代價遠大於其助益，因此識別出什麼是無效的醫療，並提供對患者有助益的照護計畫十分重要。我國政策上擬將建立重症病患末期無效醫療的評估及照護標準，但事實上無效醫療的界定十分不易。因此，無效醫療是所有醫療照護者應須了解的重要議題，本文即先闡述無效醫療的生命倫理觀點，並說明無效醫療的定義及其爭議與相關研究，期能增進醫護人員對無效醫療議題的瞭解與重視。

關鍵字

無效醫療；無益醫療；生命倫理

並列摘要

Although able to extend the life of some critical patients, advanced medical technology is limited in terms of scope and extent of effectiveness. Some patients die despite the best efforts of medical teams. Medical futility describes treatments that are both extremely unlikely to benefit a patient and costly to provide. Clearly defining futile treatments and considering this concept in patient care strategies is important to provide quality patient care. Taiwan is currently formulating a policy on medical futility. While accepting that the term ”futile” is used in many different ways and that this term is difficult to define in clinical practice, this article discusses the various ethical views on medical futility and its definition, the debate among these different views, and related research. We hope this article may help medical care staff better understand the importance of medical futility.

並列關鍵字

medical futility ； non-beneficial treatment ； biomedical ethics

參考文獻

林芳如、黃勝堅、吳春桂、黃美玲、林亞陵、蘇玲華⋯林宏茂（2010）．重症生命末期無效醫療之探討．中華民國急救加護醫學會雜誌，21（S），1－ 8。[Lin, F. R., Huang, S. J., Wu, C. K., Huang, M. L., Lin, Y. L., Su, L. H., ... Lin, H. M. (2010). Medical futility in critical end-oflife care. Journal of Emergency and Critical Care Medicine, 21(S), 1－ 8.]

American Medical Association Council on Ethical and Judician Affairs. (1999). Medical futility in end-of-life care: Report of the council on ethical and judicial affairs. JAMA: The Journal of the American Medical Association, 281(10), 937－941. doi:10.1001/jama.281.10.937

Bagheri, A., Asai, A., & Ida, R. (2006). Experts' attitudes towards medical futility: An empirical survey from Japan. BioMed Central Medical Ethics, 7(8), 1－7. doi:10.1186/1472-6939-7-8

Bernat, J. L. (2005). Medical futility: Definition, determination, and disputes in critical care. Neurocritical Care, 2(2), 198－205. doi:10.1385/NCC:2:2:198

Brody, B. A., & Halevy, A. (1995). Is futility a futile concept? The Journal of Medicine and Philosophy, 20(2), 123－144. doi:10.1093/jmp/20.2.123

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蕭伃伶、劉芳、戈依莉（2020）。居家安寧療護之性別差異。源遠護理，14(2)，11-17。https://doi.org/10.6530/YYN.202007_14(2).0002

林以容（2017）。生命末期醫療決策：訊息框架之研究〔碩士論文，國立臺灣大學〕。華藝線上圖書館。https://doi.org/10.6342/NTU201701350

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唐景俠、陳嘉容、黃美智（2017）。大量傷患醫療資源分配之倫理思辨－以八仙塵爆為例。護理雜誌，64(1)，105-111。https://doi.org/10.6224/JN.000014

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無效醫療議題之探討

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