醫院應遵循〈安寧緩和醫療條例〉維護病人善終權益

Hospital Should Promote Patients' Right of Peaceful Dying According to the ＂Hospice Palliative Care Act＂

陳榮基(Rong-Chi Chen)

《醫院雙月刊》 48卷1期 (2015/02) Pp. 7-12

摘要

醫生的天職是把病人救活，把疾病治好，將痛苦解除，促進人類的健康。但是當生命已走到盡頭，死亡已是不可避免時，醫師與醫院，應該以最大的愛心及人性的關懷，來提供給每一個病人沒有痛苦，能夠安詳有尊嚴的往生的機會。請大家響應衛福部「尊重末期病人的生命及其醫療自主權」的呼籲，努力推動安寧緩和醫療的理念。期待台灣各個醫學會早日對各器官系統衰竭病人訂定安寧緩和醫療的指引，各級醫院醫療人員能善用安寧緩和人性化醫療的理念與愛心，以病人的最大利益為考量，面對病人與家屬，努力宣導安寧理念及政府推動預立DNR意願書的精神。ICU的醫師，面對已經插管急救仍然無法恢復呼吸且持續極重度昏迷的病人（台灣昏迷指數0分），如果研判不可能恢復，應該與家屬耐心溝通，根據病人簽署的不施行維生醫療意願書或家屬代表簽署的不施行維生醫療同意書，儘早依法撤除無效的呼吸器等措施，減少及縮短病人的痛苦，協助病人善終，並減少醫療糾紛。

關鍵字

安寧緩和醫療條例 ； 自然死法案 ； 善終 ； 心肺復甦術 ； 維生醫療 ； 台灣昏迷指數

並列摘要

The purpose of medicine is to prevent illness, to cure disease, to relieve suffering and to maintain health. The duty of the physicians and hospitals, of course, is to rescue life, to cure disease, to relieve suffering and to promote health. When a person has reached the end of his life, when death is impending, the duty of medical professionals will be to provide love and humanistic care for the patient, to relieve pain and suffering and provide a peaceful and dignified demise. At the end of terminal care, physicians should maintain a religious and holistic spirit of ＂removal of suffering and provision of happiness＂ to their patients, as much as he could. Provision of hospice palliative care and terminal DNR according to medical ethics and law can ensure peaceful dying of the patients. The use of Taiwan Coma Scale might improve our quality of terminal care at ICU.

並列關鍵字

Hospice palliative care ； peaceful dying ； good death ； Taiwan coma scale ； medicolegal dispute ； futile medicine ； Hospice palliative care act ； Natural death act