Giving life, giving death: ethical problems of high-technology medicine.

摘要: High-technology medicine, such as dialysis and transplantation is limited nowhere can all potential beneficiaries receive it. Although very successful, high-technology medicine sometimes makes dying to a cruel spectacle patients whose lives depend on machine want stop. The resulting ethical questions revolve around just distribution of life support - giving life, withdrawal in death. We investigated distributive justice life-support by setting the number accepted for relation those who died renal failure transplanted waiting chronic dialysis. In both Sweden USA, transplantation, older received less treatment than younger ones. Seventy-year old people had 1/10 chance 20-40 year receiving 1/30 transplant. Women between 70%-90% men countries. Black were more often dialyzed, but USA. Neither Sweden, nor USA has been achieved transplantation. Similar problems have reported other areas medicine. studied withdrawal, i.e. passive euthanasia, found that 10% begun because it was stopped, although there no medical or technical reason. Stopping caused 22% deaths. Half made decision stop themselves. half incompetent families physicians decided discontinue let patient die. competent similar decisions seem same ground groups suggesting are appropriate surrogate decision-makers patients. Home withdrew from dialysis, three times center did not harm surviving relatives, relatives complained poor physician communication. Old shorter survival excluded from, stopped dialyses ten young However, ratio mortality compared population at large higher self-reported quality particularly high.(ABSTRACT TRUNCATED AT 400 WORDS)