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Ethical issues at the end of life

机译：生命终结中的道德问题

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The combination of increased life span and medical interventions has created sometimes a protracted dying process, which is the source of many ethical concerns at the end of life. Basic ethical principles, ie, autonomy, nonmaleficence, beneficence, justice, and double effect, are the cornerstones of decisions made at the end of life. Examples of items being discussed are: informed consent, advanced directives, surrogate, DNR, hospice and palliative care. New concepts such as "limit settings" on interventions at the end of life or "futility" are now applied. Those new trends have led to situations when patients are given by physicians the means to end their lives by themselves (physician-assisted suicide) or with the help of a health professional (euthanasia) to relieve patients' suffering. Several professional medical organizations (AMA, ACP, AAHPM, for instance) provide ethical guidelines and may help solve end-of-life clinical problems which sometimes present some of the most challenging ethical dilemmas.
机译：寿命的延长和医疗干预的结合有时会导致长期的死亡过程，这是生命终结时许多道德问题的根源。基本的道德原则，即自治，非恶意，慈善，正义和双重影响，是生命终结之初做出决定的基石。讨论的项目包括：知情同意，高级指示，替代，DNR，临终关怀和姑息治疗。现在应用了新概念，例如寿命终止时的“限制设置”或“徒劳无益”。这些新趋势导致了以下情况：医生为患者提供了一种可以自行结束生命的方式（医生协助自杀）或在卫生专业人员的帮助下（安乐死）减轻了患者的痛苦。一些专业的医疗组织（例如，AMA，ACP，AAHPM）提供了道德准则，并可能有助于解决临终临床问题，这些问题有时会带来一些最具挑战性的道德困境。

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