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Global versus local bioethics

机译:全球与地方生物伦理

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摘要

In this issue of Pediatric Critical Care Medicine, Dr. Pignotti takes up the Arielle's hypothetical and imaginary situation previously published by Dr. A. Janvier (1, 2). The scenario is similar (an extremely preterm baby admitted to the neonatal intensive care unit) but the actors are different. Janvier's drama is performed by Canadian doctors, nurses, parents, and baby. Pig-notti's one is played by Italian actors. In both cases, futile treatments were started. In both cases, the epilogue was the same: Arielle died. However, in the first case, the parents more or less shared the decision with the neonatologist. Conversely, in the second case, they did not participate in the decision and "are silently waiting outside the door, eyes on everyone passing by, searching for a word, a message" (2). These imaginary scenarios lead to the fundamental question, "Why do physicians from different countries behave differently toward the same ethical dilemma?" A growing literature demonstrates the high degree of variability in end-of-life (EOL) care seen throughout the world (3, 4).
机译:在本期《儿科重症监护医学》中,Pignotti博士讨论了A. Janvier博士先前发表的Arielle假设和虚构情况(1、2)。情况相似(一个非常早产的婴儿被送入新生儿重症监护病房),但演员不同。 Janvier的戏剧由加拿大医生,护士,父母和婴儿表演。 Pig-notti的电影由意大利演员扮演。在这两种情况下,都开始徒劳的治疗。在两种情况下,结尾都是一样的:阿里埃勒死了。但是,在第一种情况下,父母或多或少与新生儿科医生分享了这一决定。相反,在第二种情况下,他们没有参与决策,而是“静静地在门外等着,注视着每个经过的人,寻找一个单词,一个信息”(2)。这些假想的场景引出了一个基本问题:“为什么来自不同国家的医师在面对相同的道德困境时表现出不同?”越来越多的文献表明,全世界都可以看到寿命终止(EOL)护理的高度可变性(3,4)。

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