建構台灣的愛滋安寧療護照顧模式之雛議

Constructing Taiwan's AIDS Hospice Care Pattern's Innovate View Point

蔡佩真(Pei-Jan Tsai)

《安寧療護雜誌》 11卷2期 (2006/05) Pp. 159-165

https://doi.org/10.6537/TJHPC.2006.11(2).4

摘要

台灣的愛滋感染人口近年來急遽成長，愛滋感染者的醫療需求不斷擴大，促使醫療界以及政策制訂者必須正視愛滋感染者的需求，而需要在醫療資源的分配上，考慮資源分配的公平正義、考慮醫療人權、考慮醫療倫理、考慮危機處理的效益，而妥善發展愛滋感染者的照顧機制。台灣的安寧療護發展已臻成熟之際，這套癌症末期病人的照顧模式已經成功的實踐醫界對於善終的理想。安寧療護的成功也引發其他重症患者面對疾病末期時的盼望，特別是愛滋病患的照顧上，如何能夠讓愛滋感染者可以生死兩相安？如何能夠實踐對於愛滋病人善終照顧的承諾？愛滋病人可不可能住進安寧病房？或者，有沒有可能發展出更周延的機制來幫助愛滋病人安心的走完人生路？癌症病人的照顧模式能適用於愛滋病的末期照顧嗎？
本文試圖釐清愛滋病末期與癌症末期病人臨終處境的差異，包括死亡的污名化、病情告知原則、病危處理技術與醫療決策模式、喪葬處理、資源運用都是有差異的。最後，根據安寧療護的精神，試圖為愛滋末期病患鋪一條善終的路，並對於建構台灣的愛滋安寧療護提出最初步的建言。

關鍵字

愛滋病 ； 安寧療護

並列摘要

The HIV patients are rapidly increasing in Taiwan. The continuously enlarge requirements of medical treatment for HIV patients has urged the medical field and national health policy legislator to pay more attention to the need of HIV patients. Indeed, they should have considered: the justice of medical distribution, medical human right, medical ethics and the efficiency of dealing the crisis. Those considerations will enhance the sound functional caring system toward HIV patients. In the maturity of Taiwan’s hospice, the model of taking care of cancer terminal patients has triumphantly accomplished the idea of good death. The success of hospice causes the other fatal patients facing the terminal period with great expectation, especially in terms of nursing the AIDS patients. How to guide the HIV patients to confront either being alive of departure confidently? How to carry out the promise of good death to the AIDS patients? Can AIDS patients stay in the hospice ward? Furthermore, is there any possibility to develop a more thoughtful program to help the AIDS patients to fulfill their life races? Can the caring pattern of cancer patients fit the AIDS terminal stage?
This article attempts to identify the differences of when dying circumstances between the AIDS terminal patients and cancer terminal patients. The diversities include: die disgracefully, the principle of informing the disease status quo, the treatment to deal with critical condition, the pattern of medical policy, funeral and resource division. Finally, we try to lead the AIDS terminal patients to good death bases on the spirit of hospice. The content will also provide the initial suggestions to construct AIDS hospice in Taiwan.

並列關鍵字

hospice care ； AIDS