Říci ne lékařské technice

Dramatickým řízením osudu nedávno jeden z předních kardiochirurgů světa Michael DeBakey podstoupil v nemocnici, kde dříve působil, operaci srdce využívající techniky, již právě on kdysi vymyslel. Událost vzbudila zájem tím víc, že DeBakeymu bylo tou dobou už 97 let a operace proběhla proti jeho výslovným přáním.

Jak se doporučuje všem pacientům, DeBakey měl pokyny pro případ, že by se za jeho nemohoucnosti rozhodovalo o jeho léčbě: dokud se těšil dobrému zdraví, prohlásil, jaký přístup k lékařské péči by si přál, pokud by onemocněl a nebyl schopen za sebe hovořit. Výslovně uvedl, že nechce podstoupit závažný chirurgický zákrok.

Podstatným principem současné lékařské etiky je, že pacienti mají právo takovéto rozhodnutí učinit a lékaři jsou povinni jejich přání vyslyšet. Nedbat pacientových přání, jakmile ztratí schopnost se rozhodovat, – jak se stalo, když DeBakeyho manželka údajně vtrhla na pozdně noční zasedání etického výboru nemocnice a požadovala, aby byl chirurgický zákrok proveden – je porušením respektu k autonomii pacienta, tak těžce vybojovaného během uplynulých 20 let.

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