张卫星---放弃治疗的法律与伦理英文2.pdf

ICU中的放弃治疗 有中国模式吗？ 2012.3.9 Ethical thinking and Legal Perspective of Abandoning Treatment Zhang Wei-xing Peking University Shenzhen Hospital ICU Definition of abandoning treatment ►Do-nothing behavior of Physicians in Giving up treatment 、 Unrecoverable diseases , futile treatment Decision from patient and his/her relatives Prudential determination for physicians Case one ►Case one，female，92-year old ，Chinese American， addermission for Spontaneous Intracerebral Hemorrhage and coma ．Two times of cerebral hemorrhage in history. ►A larger-amount hemorrhage this time, deep coma, Dilated both Pupils, disappearance of light reflex, no spontaneous respiration with Mechanical Ventilation. ►No surgical operation by Neurosurgery and maintaining circulation stability in ICU. Other condition didnt show any improvement . ►Her relatives advocated treatment abandonment according to her will after being informed poor prognosis. Case two ►Case two 72 year-old female. admission to ICU for paraplegia after cervical surgery , serious pulmonary infection and renal failure. Diabetes Mellitus with Coronary Heart Disease for 10 years ►Patient was paraplegia after cervical surgery four years ago and stayed in Orthopaedics for treatment. She recurrently admitted to ICU for pneumonia and upper gastrointestinal hemorrhage. ►Patient readmitted to ICU for serious pneumonitis and abdominal distention, renal failure this time ► tracheotomy with mechanical ventilation and maintenance circulation stability in ICU. Patient and her relatives proposed rejection of invasive emergency therapy ． Case