我國安寧緩和照護之相關政策的過去發展與未來展望

Hospice Palliative Care Policy in Taiwan: Past Developments and Future Perspectives

陳榮基(Rong-Chi Chen)

《護理雜誌》 62卷2期 (2015/04) Pp. 13-17

https://doi.org/10.6224/JN.62.2.13

摘要

醫護人員要「救生」，也要「顧死」，照顧病人，應該是「從子宮到墳墓」，從出生到死亡，而最後階段的臨終關懷，更應發揮「拔苦予樂」的宗教情操與人文精神。1990年馬偕醫院在淡水分院設立「安寧病房」，是我國安寧療護實務的開始。健保的給付、〈安寧緩和醫療條例〉的立法、醫院評鑑的重視與臨床宗教師制度的建立，使安寧工作能夠順利開展。未來希望加護病房推行台灣昏迷指數，可以縮短臨終病人的痛苦與減少醫療資源的浪費。期許將來能夠全面推廣社區安寧照護，讓大部分的病人能夠壽終正寢，在家中安詳往生。

關鍵字

安寧緩和照護 ； 安寧緩和醫療條例 ； 自然死法案 ； 善終 ； 台灣昏迷指數

並列摘要

The duty of medical personnel is to save lives, cure diseases, relieve suffering, and promote health. Medical personnel care for their patients from birth to death. At the end of terminal care, medical personnel should maintain a religious / holistic commitment to their patients to ＂remove their suffering and provide happiness＂ as much as possible. Mackay Hospital opened the first hospice in Taiwan in 1990. Financial coverage of hospice care by the National Health Insurance, the enactment of the Hospice Palliative Act, the attention of Hospital Accreditation to hospice care, and the establishment of the system of clinical chaplaincy have all contributed to the development of hospice palliative care in Taiwan. Application of the Taiwan Coma Scale has been shown to decrease the use of futile life sustaining treatments in the ICU. The author hopes that nurses may further expand community hospice care services to help facilitate the peaceful dying of terminal patients at home.

並列關鍵字

hospice palliative care ； hospice palliative care act ； natural death act ； peaceful dying ； Taiwan coma scale

參考文獻

陳榮基（2014）．台灣昏迷指數：格拉斯哥昏迷指數修訂版．安寧療護雜誌，19（2），176–180。[Chen, R. C. (2014). Taiwan coma scale: A modified Glasgow coma scale. Taiwan Journal of Hospice Palliative Care, 19(2), 176–180.]

陳榮基（2006）．醫界應積極推廣臨終DNR的觀念．慈濟醫學雜誌，18（2），155–157。[Chen, R. C. (2006). Medical personnel should actively promote the concept of terminal DNR. Tzu Chi Medical Journal, 18(2), 155–157.]

Sogyal Rinpoche. （2006）．西藏生死書（鄭振煌譯，246頁）．台北市：張老師文化。（原著出版於1992年）[Sogyal Rinpoche. (2006). The Tibetan book of living and dying (C. H. Cheng, Trans., p. 246). Taipei City, Taiwan, ROC: Living Psychology.]

安寧緩和醫療條例．總統華總一義字第10200000811號令修正（2013，1月9日）。[Hospice Palliative Care Act, President Order Hua Chung(1) Yi Tze No. 10200000811 amended. (2013, January 9).]

陳榮基（2009）．臨終關懷的人文精神．於戴正德、李明濱編著，醫學人文概論（第七章，97–109頁）．台北市：教育部。[Chen, R. C. (2009). Humanism in terminal care. In C. T. Tai & M. B. Lee (Eds.), Medical humanities (Chap. 7, pp. 97–109). Taipei City: Ministry of Education, Taiwan, ROC.]