臨床神経学

第51回日本神経学会総会

<シンポジウム20―2>神経内科領域における終末期の倫理的問題について
いわゆるTLS状態のALS患者をめぐる生命維持中止の問題―臨床倫理の視点から

清水 哲郎

東京大学大学院人文社会系研究科上廣死生学講座〔〒113―0033 東京都文京区本郷7―3―1〕

In Japanese context, there has been a controversy concerning the withdrawal of life-support, i.e. respiratory system, from ALS patients when, along of the progress of the disease, they have become not able to express themselves at all to people around them, i.e. when they are in so called 'totally locked in state (TLS)'. Basing himself on the system of clinical ethics he has been developing in accord with Japanese culture, the author (1) reconstitutes the logic of justifying the withdrawal in dispute, (2) examines objections against officially recognizing such withdrawal, and (3) proposes an appropriate process of decision making which he hopes to be acceptable to both sides in the controversy.
Full Text of this Article in Japanese PDF (182K)

(臨床神経, 50:1029−1030, 2010)
key words:臨床倫理,TLS,生命維持の中止,ALS(筋萎縮性側索硬化症),日本の事情

(受付日:2010年5月22日)