Ethics in Intensive Care Medicine

在這本書中，作為歐洲重症醫學學會（ESICM）教科書系列的一部分，臨床倫理領域的專家們描述了臨床倫理和倫理推理的基本原則，這些原則是重症醫學的根本支柱，以及為每位患者做出適當決策所需的決策過程。具體而言，書中詳細闡述了有關限制生命延續療法和將緩和醫療整合進重症醫療的複雜決策過程。此外，仍具爭議的倫理氣候、比例護理和優先排序等主題也得到了深入探討。所謂的「軟技能」——跨專業的溝通與合作，獲得了應有的重視，以克服技術進步與人際關係停滯之間的鴻溝。最後，Covid-19 疫情挑戰了廣泛接受的倫理價值觀和原則，迫使臨床醫生制定有關稀缺資源優先排序的建議。

這本書將成為臨床醫生理解倫理原則和推理的重要工具，以應對重症醫學中跨越學科和職業的倫理挑戰，從而為患者提供適當的個別治療計劃。

Series Editors

Prof. Maurizio Cecconi is Head of Department Anaesthesia and Intensive Care Units, IRCCS Istituto Clinico Humanitas, Rozzano (MI), Italy and Professor of Anaesthesia and Intensive Care, Humanitas University, Pieve Emanuele (MI), Italy. His main fields of research are haemodynamic monitoring, haemodynamic optimisation and physiology of the critically ill patient. He has published extensively and has specific interest in haemodynamic monitoring and fluid management of the critically ill.

Prof. Daniel De Backer is Professor of Intensive Care at the Université Libre de Bruxelles, Brussels, Belgium Head of Intensive Care Departments of CHIREC Hospitals (Brussels and Braine l'Alleud-Waterloo). His main fields of investigation are severe sepsis, organ dysfunction, acute circulatory failure and its treatment (in particular vasoactive agents), haemodynamic monitoring, hepato-splanchnic circulation and microcirculatory disorders.

Andrej Michalsen, MD, MPH, was born 1957 in Überlingen/See, Germany. He received his medical training at the medical schools of Kiel, Freiburg and Tübingen universities as well as at the University of Texas School of Public Health in Houston, TX, U.S.A., and he has worked at the academic hospitals of Mainz, Germany, and Utrecht, the Netherlands. He is currently working as a consultant in Anaesthesiology and Critical Care at Konstanz Hospital, Germany. Amongst others, he is a member of the Section on Ethics of the European Society of Intensive Care Medicine (which he chaired from 2013 until 2016), a member of the Ethics Section of the German Interdisciplinary Association of Intensive Care and Emergency Medicine, and a member of the Ethics and Conflict of Interest Committee of the American Thoracic Society. He has published and lectured extensively in the field of clinical ethics, his main areas of interest particularly comprising end-of-life care, appropriateness of care and prioritization in health care delivery.

Dr. Sadovnikoff obtained his medical degree from Brown University in 1984. He is trained and board-certified in Internal Medicine, Critical Care Medicine and Anesthesiology, and was for 16 years the Co-Director of the Surgical Intensive Care Units as well as program director of the Fellowship in Anesthesiology Critical Care at Brigham and Women's Hospital (BWH) in Boston, MA He was inducted as a fellow in the American College of Critical Care Medicine (FCCM) in 2008. He is currently Interim Chair of the Department of Anesthesiology, Critical Care and Pain Medicine at St. Elizabeth's Medical Center in Brighton, MA.

In 2008-9, he completed the Fellowship in Medical Ethics at Harvard Medical School. He served for seven years as Co-Chair of the BWH Ethics Committee, was Associate Director of the BWH Office of Clinical Ethics and has achieved certification in Healthcare Ethics Consultation (HEC-C). He is the Vice-Chair of the ASA Committee on Ethics and was the 2019 recipient of the Shubin-Weil Master Clinician/Teacher Award from the Society of Critical Care Medicine. He is Co-Editor with Dr. Andrej Michalsen of an international volume of articles entitled Compelling Ethical Challenges in Critical Care and Emergency Medicine (Springer, 2020).

Jozef Kesecioglu is Professor of Intensive Care Medicine at the Department of Intensive Care Medicine, University Medical Center, Utrecht, the Netherlands. He has been the chair of the Department of Intensive Care Medicine between 2005-2020. During this period, he has re-organised the pre-existing four intensive care units and made one department of it before designing and moving to the new, award winning, state-of-the-art ICU.

Professor Kesecioglu was Chairman of the Ethics Section of the European Society of Intensive Care Medicine (ESICM). After finishing his term, he worked in the Executive Committee of ESICM as the Chair of the Division of Scientific Affairs. In 2016, he is has become the President Elect of ESICM. He has been the President of ESICM between 2018-2020. He was awarded with ESICM Society Medal in 2022.

Professor Kesecioglu has authored around 175 published or in-press peer-reviewed papers and has been giving lectures in various scientific meetings. His main interests are ethics, intensive care environment, and selective decontamination of the digestive tract.

系列編輯

教授 Maurizio Cecconi 是意大利羅茲安諾（Rozzano, MI）IRCCS Istituto Clinico Humanitas 麻醉與重症監護科的主任，以及人文大學（Humanitas University, Pieve Emanuele, MI）麻醉與重症監護的教授。他的主要研究領域包括血流動力學監測、血流動力學優化及重症病人的生理學。他在這些領域有廣泛的出版，特別關注重症病人的血流動力學監測和液體管理。

教授 Daniel De Backer 是比利時布魯塞爾自由大學（Université Libre de Bruxelles）重症監護的教授，並擔任 CHIREC 醫院（布魯塞爾及布雷納爾-阿勒德-滑鐵盧）的重症監護科主任。他的主要研究領域包括重度敗血症、器官功能障礙、急性循環衰竭及其治療（特別是血管活性藥物）、血流動力學監測、肝脾循環及微循環障礙。

卷編輯

Andrej Michalsen 醫生，公共衛生碩士，於1957年出生於德國烏伯林根（Überlingen/See）。他在基爾、弗賴堡和圖賓根大學的醫學院以及美國德克薩斯州休士頓的德克薩斯大學公共衛生學院接受醫學訓練，並曾在德國美因茨和荷蘭烏特勒支的學術醫院工作。目前，他在德國康斯坦茨醫院擔任麻醉學和重症監護的顧問。他是歐洲重症醫學學會倫理學部門的成員（2013年至2016年擔任主席），德國重症與急救醫學跨學科協會倫理學部門的成員，以及美國胸科醫學會倫理與利益衝突委員會的成員。他在臨床倫理領域有廣泛的出版和演講，主要關注的領域包括臨終關懷、醫療適當性及醫療服務的優先排序。

Sadovnikoff 醫生於1984年獲得布朗大學的醫學學位。他在內科、重症醫學和麻醉學方面接受過訓練並獲得專業認證，並在布萊根婦女醫院（Brigham and Women's Hospital, BWH）擔任外科重症監護單位的聯合主任及麻醉重症醫學獎學金計畫的主任長達16年。他於2008年被選為美國重症醫學學會（FCCM）會員。目前，他是麻醉學、重症監護和疼痛醫學部門的臨時主任，任職於麻薩諸塞州布萊頓的聖伊莉莎白醫療中心。

在2008至2009年期間，他完成了哈佛醫學院的醫學倫理獎學金。他曾擔任 BWH 倫理委員會的聯合主席七年，並擔任 BWH 臨床倫理辦公室的副主任，並獲得醫療倫理諮詢認證（HEC-C）。他是美國麻醉學會倫理委員會的副主席，並於2019年獲得重症醫學學會的 Shubin-Weil 大師臨床醫生/教師獎。他與 Andrej Michalsen 醫生共同編輯了一本名為《重症醫學和急救醫學中的重要倫理挑戰》（Compelling Ethical Challenges in Critical Care and Emergency Medicine，Springer, 2020）的國際文章集。

Jozef Kesecioglu 教授是荷蘭烏特勒支大學醫學中心重症醫學系的教授。他在2005至2020年間擔任重症醫學系主任。在此期間，他重新組織了原有的四個重症監護單位，並將其整合為一個部門，隨後設計並搬遷至新的、獲獎的先進重症監護病房。

Kesecioglu 教授曾擔任歐洲重症醫學學會（ESICM）倫理學部門的主席。任期結束後，他在 ESICM 的執行委員會中擔任主席。