生死学视域中的“坏消息”告知

"Bad News"Disclosure from the Perspective of Life-and-Death Studies

患者被隐瞒坏消息的主要理由是保护其免受恶性病情信息的打击。而主张告知患者坏消息则有四个重要理由。告知坏消息必要但不绝对,最终是否告知应当取决于患者的知情意愿,而且如果告知还需征得家属同意。强调应该由医生告知坏消息,而不是护士、社工、志愿者等。在坏消息告知方式上,强调以医护团队为主体的生死学场域的提前构建,生死学场域的构成则包括医护人员的叙事素养、生死学科普活动以及医院生死文化三个要素,其中生死学科普活动最为重要。

The main reason that patients are kept from bad news is to protect them from the impact of malignant disease information.There are four important arguments for informing patients of bad news.Disclosing bad news is necessary but not absolute,whether to disclose ultimately depends on the patient's informed willingness,and disclosure should also obtain the consent of the family.The paper emphasizes that bad news should be delivered by doctors,not nurses,social workers,volunteers,etc.In terms of the way to inform the bad news,the author emphasizes the advanced construction of the life-and-death field with the medical team as the main body.The composition of the life-and-death field includes three elements:the narrative competency of medical staff,the life-and-death science popularization activities and the life-and-death culture of the hospital,among which the life-and-death science popularization activities are the most important.