先天性畸型新生兒不施行心肺復甦術的倫理抉擇

Ethical Decision Making for Newborns with Congenital Abnormalities: The 'Do Not Resuscitate' Dilemma

張麗娟(Li-Chuan Chang) ； 黃美智(Mei-Chih Huang)

《護理雜誌》 56卷3期 (2009/06) Pp. 99-104

https://doi.org/10.6224/JN.56.3.99

摘要

由於醫療科技的提升，使得許多具生命威脅性之先天性畸形新生兒得以延緩死亡，致使新生兒加護中心(neonates intensive care unit)常出現倫理困境。本文藉由Jonsen等人所提出的四主題方法，探討一位罹患愛德華氏症候群新生兒不施行心肺復甦術的倫理抉擇。分析結論為當先天性畸形的新生兒為無效醫療的情況下，以病患的生活品質為前提，在尊重父母決定下，不施行心肺復甦術，但是應協助父母面對新生兒的死亡，給予先天性畸形的新生兒安寧療護，得到善終。

關鍵字

先天性畸形新生兒 ； 不施行心肺復甦術 ； 倫理抉擇

並列摘要

Neonatal intensive care units face increasing ethical dilemmas as advancing medical techniques prolong the dying process of newborns with life-threatening congenital abnormalities. This article explores the ethical dilemma posed with regard to a newborn suffering from Edwards syndrome. The issue whether or not to resuscitate was approached using Jensen's four topics method. Under conditions of medical futility, the presupposition of a poor quality of life for the child and respect for parental autonomy, a decision was made against resuscitation. Medical professionals have a responsibility to help parents deal with the dying process through palliative care that provides a good death for newborns suffering from severe congenital abnormalities.

並列關鍵字

congenital abnormal newborn ； do not resuscitation DNR ； ethical decision making