美国临终医疗观念的历史形塑与启示

The Historical Shaping and Enlightenment of End-of-life Medical Concept in the United States

基于史料梳理与临床数据解读,美国临终医疗观念的形塑深受个人主义与进取精神、社会过度期待以及医疗利益结构影响。伴随而来的是,美国临终过度医疗现象逐渐产生。其临终过度医疗手段引发了技术垄断、道德伦理、患者自主权等诸多社会争论,为我国构建和完善临终关怀服务体系给予深刻的现实启示。为实行全生命周期的科学养老、理性治疗,需要进一步加强安宁疗护模式的制度推进、生命死亡教育的意识培育与进步医学思维的文化扭转。

Based on the review of historical materials and interpretation of clinical data,the shaping of the concept of end-of-life care in the United States has been deeply influenced by individualism,entrepreneurial spirit,excessive societal expectations,and the medical interest structure.The phenomenon of excessive medical treatment at the end of life in the United States has gradually emerged.The excessive end-of-life care measures have triggered many social debates such as technology monopoly,moral ethics,and patient autonomy,providing profound practical inspiration for the construction and improvement of the end-oflife care service system in China.In order to implement scientific elderly care and rational treatment throughout the life cycle,it is necessary to further strengthen institutional promotion of hospice care model,cultivate consciousness of life and death education,and promote a cultural shift towards progressive medical thinking.