判断医疗无效:医学与哲学的分析

Judging Medical Futility:Analysis of Medicine and Philosophy

医疗是否无效可以从生理角度、生命素质或疗程成功率三方面去评估。无论是用科学方法、质量方法或数量方法去评估医疗是否无效 ,它们都各自含有主观的价值观念。因此 ,医疗无效不是一个客观或价值中立的概念。医患之间任何一方的价值观念都不应具有优先权利。最合理的方法是容许双方的价值观有平等参与决策的机会 ,包括医疗的目标与期望 。

Medical futility which can be determined scientifically in terms of physiological changes,or qualitatively in terms of improvement in quality of life,or quantitatively in terms of probability of success.But none of these methods can be shown to be entirely objective and value-free,and the notion of medical futility,as all other health care concepts,incorporates ethical and cultural value components.We propose that priority should not be given to any one group,and the best solution is to adopt a shared decision-making process where the values of physician/team members and patient/family members are allowed to influence the goals and expectations of treatment as well as the criteria for determining its failure and futility.