An Ethical Study On Forgoing Treatment Of Terminal Cancer Patients In Medical Institutions Of Guangzhou

Objective:The development of the Modern Medicine enables a growing numbers of sick people of incurable disease maintains their lives through the advanced drugs an d medical equipments. However, due to the endurable pain from the disease, the costly treatment, and the poor-quality life and some other reasons, the patients’relatives or even the patients themselves, choose to quit the therapy finally. Compared with many western countries, Hong Kong and Taiwan, there is not a clear definition to the rights of the patients,doctors and the deputy of the patients regarding forgoing treatment. The rights of patients can not be protected at the best. For this reason, this paper studied the status of forging treatment of terminal cancer patients in Guangzhou, analysis the affecting factors, discussing the ethical problems, in order to provide a reference for the forgoing treatment system.Methods:(1) Reviewing the medical history.Choose four hospital in Guangzhou, reviewing the medical history of the cancer patients from2012to2014,total458cases, we got the general information of the patients, including:demographic characteristics, the disease status, conditions of the patients when being treated in the hospital for the1ast time, when and why and under what condition did the patients chose the forgoing treatment, who signed the letter of authorization, and the letter of forgoing treatment and under what condition were these letter signed, and some other special cases.(2)Statistical analysis. By spssl7.0statistical software, using the chi-square test of independence and fisher’s exact test for data correlation, we get the relevant factors including:type of treatment in the hospital for the last time; days of hospitalization; The moment,type and reason of forgoing treatment; the letter of authorization; and the letter of forgoing treatment.(3) Law research.Research the law of western countries and other areas, make suggestions for the current ethical problems.Results:(1)The survey results shows:different age, confirmed time, the treatment before are statistically significant for the time of forgoing treatment(P<0.05); different confirmed time, the treatment before,numbers of children, payment of medical expenses are statistically significant for the type of forgoing treatment(P<0.05); different age, payment of medical expenses,the treatment before are statistically significant for the cause of forgoing treatment(P<0.05); different education level and self-care ability are statistically significant for the validity of a letter of authorization (P<0.05); the numbers of children are statistically significant for the validity of a forgoingletter(P<0.05)treatment;the daily caretaker plays a great influence on the deputy and the signatory of the letter of forgoing treatment (P<0.05); payment of medical expenses isstatistically significant for days of hospitalization (P<0.05);age and payment of medicalexpenses is statistically significant for the type of before treatment (P<0.05). But maritalstatus, religion, numbers of children are not statistically significant for days ofhospitalization, the type of before treatment, time and cause of forgoing(P>0.05); maritalstatus, numbers of children, payment of medical expenses are not statisticallysignificant for the validity of a letter of authorization(P>0.05); marital status, the level ofthe education are not statistically significant for tho sigh the letter of forgoingtreatment(P>0.05); marital status is not statistically significant for the type of forgoingtreatment(P>0.05).(2) The survey revealed some ethic problems in forgoing treatment,such as: most patients’ autonomy cannot be reflected from agent authorization to signingforgo treatment notice. Lacking corresponding supervision and management mechanismon performing forgo treatment etc.Conclusion: The survey found that the patient’s age, payment of medical expenses, thenumber of children have a greater impact on forgoing treatment. In forgoing treatmentprocess, there is no respect for patient autonomy and other ethical issues. Owing to theseproblems, doctors and the management should be pay attention to the relevant factors offorgoing treatment, respect for patient autonomy, guide the patients’ relatives concernedabout the autonomy of life and quality of life of dying, If we doing so, not only helps toreduce medical disputes and promote harmony between doctors and patients, but alsohelps to establishment the treatment system.