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Limitation of the therapeutic effort: ethical and legal justification for withholding and/or withdrawing life sustaining treatments

机译:治疗工作的局限性:扣留和/或退出维持生命治疗的道德和法律依据

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摘要

Withholding and withdrawing a treatment already established are two forms of limitation of the therapeutic effort (LTE). The question of undergoing or not undergoing lifesaving medical treatments is not restricted to a specific health care context, as it refers to a variety of treatments, and it does not concern a restricted group of diseases. LTE has become part of the options compatible with the good clinical practice, in accordance with a deep change in modern medicine’s ‘mission’ along with the increased importance attributed to the patient’s general, personal condition, and to the quality of his/her life. However, LTE remains a controversial issue, and it still has many opponents, in particular, but not exclusively, in those cases in which the question is the withdrawal of treatments, which a widespread conventional wisdom considers ethically and legally different from not initiating treatments. But is it justified to address LTE as a totally controversial issue, especially in case of withdrawal of treatments? The paper answers negatively by arguing that there are criteria both in medical ethics and in law often adequate enough to remove doubts, and to guide decisions and actions.
机译:停止和撤回已经建立的治疗是限制治疗效果(LTE)的两种形式。接受或不接受挽救生命的药物治疗的问题并不局限于特定的医疗保健环境,因为它涉及多种治疗方法,并且与有限的疾病类别无关。随着现代医学“使命”的深刻变化以及患者的一般状况,个人状况以及生活质量的提高,LTE已成为与良好临床实践兼容的选项的一部分。但是,LTE仍然是一个有争议的问题,在问题是撤消治疗的情况下,LTE仍然有许多反对者,尤其是(但不仅限于),这是一种普遍存在的传统观念,从伦理上和法律上都与不采取治疗的观点不同。但是是否有理由将LTE视为一个完全有争议的问题,尤其是在退出治疗的情况下?该论文否定了答案,认为医学伦理学和法律中都存在足以消除疑虑,指导决策和行动的标准。

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