从一例疾病叙事管窥临终医疗的伦理困境

Study on the Ethical Dilemma of Hospice Care from a Disease Narrative

基于某医院神经内科所收集的疾病叙事个案及对两个城市几家三甲医院医生(分别任职于ICU、神内、神外、胸外,产科及急诊外科)的电话访谈,分析患者临终医疗时所面对的生命伦理困境,并对无效治疗、自主决定权、生命尊严等问题进行反思和探讨。在患者从满意治疗到无效治疗的过程中,需要最大限度地减少或弱化理性救治与感性关怀之间的矛盾,从人道主义立场关注濒临死亡的患者,给予他们身体、心理、社会的全面照护,满足患者及家属最后的心愿。

Based on the disease narratives collected by the department of neurology of a hospital,and telephone interviews with doctors from several Three-A hospitals,who worked in ICU,neurology,neuro surgery,thoracic surgery,obstetrics and emergency surgery respectively,this paper analyzed the dilemma of bioethics faced by patients in the end of their life,and discussed the problems of invalid treatment,independent decision-making power,life dignity and so on.In the process of patients from satisfactory treatment to ineffective treatment,it is necessary to minimize or weaken the contradiction between rational treatment and emotional care,pay attention to the dying patients from the humanitarian standpoint,give them comprehensive physical,psychological,social care,and meet the final wishes of patients and their families.