漸凍人呼吸器之撤除：一個案報告

Removal of Mechanical Ventilator: A Case Report

呂映瑾(Ying-Chin Lu) ； 陳冠廷(Kuan-Ting Chen)

《安寧療護雜誌》 14卷1期 (2009/03) Pp. 70-79

https://doi.org/10.6537/TJHPC.2009.14(1).7

摘要

本文個案是一位末期的漸凍人，於2008年6月25日因呼吸困難於本院急診室被插上氣管內管，並入住加護病房使用呼吸器，個案瞭解使用呼吸器可延長生命，卻無法帶來更好的生活品質與生命尊嚴，因此選擇不做氣管切開術，於7月14日要求會診安寧共照醫師，並要求給予撤除呼吸器，於7月15日轉入安寧病房準備撤除呼吸器，筆者照護期間自7月15日至8月9，期間經歷末期漸凍人接受呼吸器維生設備，住院並接受的安寧照護的過程，及該患者撤除呼吸器後的末期安寧照護情形，依法律上、倫理上、情感上等各層面來深入探討。

關鍵字

肌萎縮性側索硬化症 ； 緩和醫療

並列摘要

A patient with terminal Amyotrophic Lateral Sclerosis (ALS) was intubated at emergency room because of dyspnea on June 25, 2008. Then, he needed to utilize mechanical ventilator for respiratory support and was transferred to the intensive care unit. The patient understood the mechanical ventilator could prolong the survival time, but not improve the quality of life and dignity. Finally, patient decided not to perform the tracheotomy. After discussion with palliative shared-care doctor on July 14, he requested for ventilator withdrawal and was transferred to the hospice ward on the next day. The authors provided palliative care for the patient until August 9. The course of hospice care and ventilator withdrawal for this patient would be discussed in legal, ethical and emotional aspects.

並列關鍵字

Amyotrophic Lateral Sclerosis ； palliative care