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医師による助死自殺の要請に応答する: "これは私たち2人のための未知の水域です"
1Division of General Internal Medicine and Geriatrics, L475, Center for Ethics in Health Care, Oregon Health & Science University, Portland, OR 97201, USA. bascomp@ohsu.edu
JAMA
|July 2, 2002
まとめ
死にかけている多くの患者は,医師による自殺支援 (PAS) を検討していますが,その多くはそれを要求しません. 患者の懸念に対処することは,しばしば苦しみを軽減し,PASのない人の願いを満たします.
科学分野:
- 医療倫理 医療倫理について
- 緩和ケアとは,緩和ケアです.
- 終末期の研究について
背景:
- 医師による自殺 (PAS) は,多くの患者によって考慮されている複雑な終末期オプションです.
- PASに対する患者の関心は,彼らの懸念が解決されるにつれて,しばしば減少します.
研究 の 目的:
- 医師による自殺支援の要求の背後にある患者の動機を調べる.
- 終末期ケアにおける患者の根本的な懸念に対処することの重要性を強調する.
主な方法:
- 死にかけている患者のPASに対する態度に関する研究のレビュー.
- PASに対する患者の要求に影響を与える要因の分析.
- アミオトロフィック横筋硬化症 (ALS) とPAS要求の患者のケースイラスト.
主要な成果:
- 瀕死の患者の約50%がPASの選択肢を望んでいますが,特にそれを要求するのは1%だけです.
- PASに対する患者の願望は,根本的な恐怖や懸念が特定され,対処されたときに大幅に減少します.
- 患者の期待,恐れ,終末期ケアオプションに関する包括的な議論が不可欠です.
結論:
- 医師は,PASの要求に対する患者の動機を探求し,苦しみを軽減し,懸念に対処することに焦点を当てなければなりません.
- 患者の懸念を理解し,対処することは,しばしばPASに頼ることなく,患者の願望を叶えることにつながります.
- 医者の個人的な,道徳的,法的懸念は,終末期ケアオプションに関するオープンな対話を妨げてはならない.
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