Case Studies

Permissibility to Stop Off-Label Use of Expensive Drug Treatment for Child

停止施於兒童之昂貴藥物的適應症外使用註一

 

文/Daniel A. Beals醫師 <http://cbhd.org/content/daniel-beals-md>

專欄編輯/Robert D. orr醫師(生命倫理暨人類尊嚴中心(CBHD)臨床倫理學顧問)

譯/林雅庭

 

編註:以下報導乃基於真實的醫療倫理諮商案件,為保護病患隱私部分細節予以保留。本專欄旨在提出各種病患、家屬,以及專業醫護人員可能面臨的醫療困境,並提供詳盡的分析和符合聖經教導的建議。本文格式與文長皆盡可能模仿真實的醫院記錄,而不求徹底的議題探討。

 

問題

 治療高雪氏症(Gaucher’s disease)註二病童時,若昂貴藥物的適應症外使用並無療效,且病童可能因持續用藥而受苦,在倫理上可否停止施藥?

案例

Podcast Episode: 
82

The Rights and Responsibilities of Pregnant Women

懷孕婦女的權利與責任

Dr. Susan M. Haack撰,Robert D. Orr編輯

2009年1月23日發表

林雅庭 譯

 

討論問題

   在道德上,懷孕婦女可以放棄對腹中胎兒進行有利的救命治療嗎?

Podcast Episode: 
106

Clinical Ethics Dilemmas: Experiencing Differences Between European and American End-of-Life Care

 Editor’s Note: This column presents a problematic case that poses a medical-ethical dilemma for patients, families, and healthcare professionals.  As it is based on a real situation, some details have been changed in the effort to maintain confidentiality.  In this case, the medical community is unaware of the treatment plan recommended by a foreign physician.

Podcast Episode: 
175

Clinical Ethics Dilemmas: Capitulation to a Patient’s Demands

Editor’s Note: This column presents a problematic case that poses a medical-ethical dilemma for patients, families, and healthcare professionals. As it is based on a real case, some details have been changed in the effort to maintain patient confidentiality. The intent of this presentation is to offer ethical analysis and medical recommendations that are consistent with biblical principles. In this case, we explore the weakness of professional healthcare when the patient is demanding, the medical team has weak communication, and there is subsequent capitulation.

Podcast Episode: 
172

Clinical Ethics Dilemmas: How Does the Doctor Decide Between Cost and Care?

Column Editor’s note:  This column presents a problematic case that poses a medical-ethical dilemma for patients, families, and healthcare professionals.  As it is based on a real situation, some details have been changed in the effort to maintain confidentiality.  In this case, the community pediatric society struggles with appropriate pediatric care in the face of considerable financial constraints.

Column editor: 
Ferdinand D. (Nick) Yates, Jr., MD, MA, Acting Consultant in Clinical Ethics, CBHD

Podcast Episode: 
169

Adolescent Confidentially: An Uneasy Truce

 

Editor’s Note: This column presents a problematic case that poses a medical-ethical dilemma for patients, families, and healthcare professionals. As it is based on a real case, some details have been omitted in the effort to maintain patient confidentiality. In this case, the doctor discusses her experience from the retrospect of the unanswered question.

Column Editor: Ferdinand D. (Nick) Yates, MD, MA; Professor of Clinical Pediatrics, State University of New York at Buffalo

Podcast Episode: 
163

End-of-Life Care in the Long-Term Cancer Survivor

 

Podcast Episode: 
158

The Need to Know: Disclosure of Information to Pediatric Patients

 

Editor’s note: This column presents a problematic case that poses a medical-ethical dilemma for patients, families, and healthcare professionals. As it is based on a real case, some details have been omitted in the effort to maintain patient confidentiality. This case and discussion point out some of the complexities in treating the minor child. While agreeing with the recommendation, the editor’s comment reflects a different paradigm for approaching the issue of a requested confidentiality purposefully withholding information from the patient.

Podcast Episode: 
152

To Dialyze or Not to Dialyze

 
 
Podcast Episode: 
140

On the Permissibility of a DNR Order for Patient with Dismal Prognosis

Editor’s Note: The following consultation report is based on a real clinical dilemma that led to a request for an ethics consultation. Some details have been changed to preserve patient privacy. The goal of this column is to address ethical dilemmas faced by patients, families and healthcare professionals, offering careful analysis and recommendations that are consistent with biblical standards.

Podcast Episode: 
121

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