Burying our mistakes: Dealing with prognostic uncertainty after severe brain injury

Prognosis after severe brain injury is highly uncertain, and decisions to withhold or withdraw life-sustaining treatment are often made prematurely. These decisions are often driven by a desire to avoid a situation where the patient becomes ‘trapped’ in a condition they would find unacceptable. Howe...

Πλήρης περιγραφή

Αποθηκεύτηκε σε:  
Λεπτομέρειες βιβλιογραφικής εγγραφής
Κύριος συγγραφέας: Graham, Mackenzie (Συγγραφέας)
Τύπος μέσου: Ηλεκτρονική πηγή Άρθρο
Γλώσσα:Αγγλικά
Έλεγχος διαθεσιμότητας: HBZ Gateway
Journals Online & Print:
Φόρτωση...
Fernleihe:Fernleihe für die Fachinformationsdienste
Έκδοση: Wiley-Blackwell [2020]
Στο/Στη: Bioethics
Έτος: 2020, Τόμος: 34, Τεύχος: 6, Σελίδες: 612-619
Σημειογραφίες IxTheo:NCH Ιατρική Ηθική 
Άλλες λέξεις-κλειδιά:B Decision-making
B prognostic uncertainty
B end-of-life treatment
B Brain injury
B Neuroethics
Διαθέσιμο Online: Πιθανολογούμενα δωρεάν πρόσβαση
Volltext (Verlag)
Volltext (doi)
Περιγραφή
Σύνοψη:Prognosis after severe brain injury is highly uncertain, and decisions to withhold or withdraw life-sustaining treatment are often made prematurely. These decisions are often driven by a desire to avoid a situation where the patient becomes ‘trapped’ in a condition they would find unacceptable. However, this means that a proportion of patients who would have gone on to make a good recovery, are allowed to die. I propose a shift in practice towards the routine provision of aggressive care, even in cases where the probability of survival and acceptable recovery is thought to be low. In conjunction with this shift, I argue in favour of a presumption towards withdrawing life-sustaining treatment, including artificial nutrition and hydration, when it becomes clear that a patient will not recover to a level that would be acceptable to them. I then respond to three potential objections to this proposal.
ISSN:1467-8519
Περιλαμβάνει:Enthalten in: Bioethics
Persistent identifiers:DOI: 10.1111/bioe.12737