The Ethical Study On Family Decision-making Of Forgoing Life-sustaining Therapy For End-of-life Patients

Due to the rapid development of the medicine,especially the emergence of life support technology,patients who originally used to be at the end of life can be sustained with the support of life support technology.Who are entitled to decide to forgo life sustaining therapy?The discussion is especially prominent.Generally speaking,there are two clinical models:patient’s autonomous decision-making and family-based decision-making.Most scholars,influenced by western bioethics,emphasize that patients should be independent and be allowed to decide whether to give up supporting treatment,and some advocate that we should learn western agency decision-making systems,such as living wills and advance directives.The standpoint of this thesis is:based on our traditional cultural background,taking the path of complete patient’s autonomy is not suitable for clinical practice in China;on the contrary,family-based decision-making is more feasible and reasonable.At the same time,different from the traditional paternalistic decision-making,the family-based decision-making proposed in this paper advocates that family members make clinical decisions on the basis of equal communication.In addition,family decision-making also needs other auxiliary means to resolve some related conflicts.This thesis consists of four parts:the first one introduces the background and significance of the research,as well as the concept of forgoing life support therapy.The second part explains the patient’s autonomy in decision-making and the family’s participation in decision-making,and sorts out the respective reasons for both pros and cons.The third part focuses on explaining the ethical implications of family decisionmaking and exploring the fundamental thoughts underlying it.In the fourth part,starting from family decision-making,we try to solves the related ethical issues of forgoing life-sustaining therapy.The innovations of this thesis are as follows:Firstly,it focuses on a specific clinical issue and deeply analyzes the ethical implications of family decision-making on this issue.Secondly,it explores the underlying thoughts behind the ideal family and the significance of family decision-making.Thirdly,it takes the form of questionnaire survey to interview several clinicians,so as to obtain clear data and conclusions,enriching the content of the paper.