关于撤回婴儿生命支持的决定引起了医生和父母之间的法律斗争,引起了媒体的强烈关注。尚不清楚我们应该如何评估婴儿的生命不再值得生活。以前尚未评估过公众对戒断治疗的态度以及父母在分歧情况下的作用。
以英国公众为样本进行了一项在线调查,以评估公众对与英国法院审理的真实案件类似的假设案件中生命益处的看法(例如,查理·加德,阿尔菲·埃文斯)。然后,我们将这些公众观点与现有的决策道德框架进行了比较。
一百三十名参与者完成了调查。大多数人(94%)认为,当幸福感低于临界水平时,婴儿的生命可能没有益处。退出治疗的决定与使用医疗资源的重要性呈正相关,婴儿建立情感关系的能力,和心理能力。在每种情况下,多达50%的参与者认为可以继续或退出治疗。
尽管有争议,我们的研究结果表明,在最严重的情况下,大多数人都认为,对于一个严重残疾的婴儿来说,生活不值得活下去。我们的调查发现,在一系列病例中,至少可以允许退出治疗,虽然也不愿推翻父母的决定。这些发现在构建临床实践指南时可能很有用。
Decisions about withdrawal of life support for infants have given rise to legal battles between physicians and parents creating intense media attention. It is unclear how we should evaluate when life is no longer worth living for an infant. Public attitudes towards treatment withdrawal and the role of parents in situations of disagreement have not previously been assessed.
An online survey was conducted with a sample of the UK public to assess public views about the benefit of life in hypothetical cases similar to real cases heard by the UK courts (eg, Charlie Gard, Alfie Evans). We then evaluated these public views in comparison with existing ethical frameworks for decision-making.
One hundred and thirty participants completed the survey. The majority (94%) agreed that an infant\'s life may have no benefit when well-being falls below a critical level. Decisions to withdraw treatment were positively associated with the importance of use of medical resources, the infant\'s ability to have emotional relationships, and mental abilities. Up to 50% of participants in each case believed it was permissible to either continue or withdraw treatment.
Despite the controversy, our findings indicate that in the most severe cases, most people agree that life is not worth living for a profoundly disabled infant. Our survey found wide acceptance of at least the permissibility of withdrawal of treatment across a range of cases, though also a reluctance to overrule parents\' decisions. These findings may be useful when constructing guidelines for clinical practice.