緩和醫療臨床開示模式之探討－以惠敏法師教學個案為例

臨床開示是針對臨終病人的憂悲苦惱，法師指出其問題所在，引導病人在臨終前以超越的模式跳脫世俗欲求無法滿足時所造成的困頓。本研究選取惠敏法師過去在台大醫院緩和醫療病房臨床教學的八名個案爲範例，就個案靈性課題整理出法師與病人之間的對話內容，再藉由病人在法師開示期間或開示之後的反應，對照並歸納出法師之臨床開示模式，進而分析臨床開示影響病人改變之機轉。結果發現法師的臨床開示模式依著「信、精進、念、定、慧」的修行次第引導病人，視臨終與平常一樣，同爲修行解脫的機會。解脫死亡恐懼的關鍵在於智慧的開啓；由法門修習中感應、證悟、理解智慧的內涵，即是在自我的身心中看見緣起、無常、無我、涅槃的特性，從而提昇內在力量，放下憂悲苦惱。

關鍵字

安寧緩和醫療；臨床開示；佛法；臨床佛教宗教師

並列摘要

Clinical disclosure is a transcendent model conducted by Buddhist Monastic to point out and solve the life and death problems when patients are suffering from sadness, fear and other spiritual distress. So far this transcendent model has not ever reported in medical literature before. In this study we reported eight cases as examples to demonstrate how Master Huimin to interact with terminal cancer patients during bedside teaching at Palliative care ward of National Taiwan University Hospital. The dialogue between Master Huimin and patients was recorded and itemized to present patient’s problems, reactions before and after disclosure, interview skills, mechanisms of problem-solving and behavior modifications. The clinical disclosure was practiced according to the principles of Buddha Dharma i.e. belief, will, practice and wisdom to enlighten patients, liberate themselves during terminal period as usual time as possible. Relief of death fear is the critical therapeutic effect for spiritual care by Buddhist chaplain. From practice of Buddha Dharma, patients can sense, aware and enlighten real life truth. In other words, knowledge comprehension stands for a basic appreciation of the principles of dependent origination and three characteristics of all conditioned existence-impermanence, unsatisfactoriness and not self, so as to enhance the nature of inner power.

並列關鍵字

hospice palliative care ； clinical disclosure ； Buddha Dharma ； clinical Buddhist chaplain

國際替代計量

緩和醫療臨床開示模式之探討－以惠敏法師教學個案為例

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