以安寧緩和療護觀點分析現代醫療的人文訴求

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以安寧緩和療護觀點分析現代醫療的人文訴求

Humanistic Thought of Modern Medicine based on Hospice Palliative Care Concepts

中文摘要

現代科技的高度發展,無庸置疑也同時帶動了醫院對相關設備大量的引進,不 但醫療儀器推陳出新,在臨床上被樂於接受及採用,醫院基於行政管理的需求 和經營成本等考量,電腦系統也成為重要的溝通工具。因此造成在整體的人際互 動上,不論是對病患、家屬等外部顧客,或是院內同仁間之內部顧客的關係上,

彼此直接接觸的頻率,在質與量的評價上都顯示出逐漸降低的趨勢,使得合於 人性需求,應該提供的完整醫療,在實施及推動方面,也產生許多負面的現象,

這對強調以服務觀念為導向的現代醫務管理而言,實在有必要對此演變多所省 思,如何在現代化洪流的衝激下,仍然保存人們彼此關懷的情愫,提供完整的 醫治。而安寧緩和療護則不同於一般傳統醫療照顧,是針對末期臨終病人及其家 屬的特別照顧。整個照顧過程中,病人有最大的自主權,家屬亦可全程參與,滿 足病人肉體的、情緒的、社會的、精神的、以及病人家屬的需要,是一種提昇末期 病人與家屬生活品質的「全人照顧」。又自八十四年三月一日全民健康保險開辦 後,台灣地區之醫療制度已經進入另一新紀元,全民健康保險制度除了改變醫 療財務結構外,對於醫療資源也重新做了分配,也因此對於民眾醫療需求與醫 療供給體系之營運,和醫療從業人員之服務產生重大影響。面對在現代醫療所陸 續顯現出來的變動與衝擊,本文期能藉由對台灣醫療發展歷史的回顧,進而以 醫學歷史洗鍊出人文教育的思考,建構成為自然科學與人文科學的橋樑,並實 際透過安寧緩和療護的醫療照顧觀點和模式,分析其間所遭遇的困擾,進而能 對現行醫療制度的更新、醫療人員的教育,以及醫療團隊的建立,提供醫學人文 訴求上的省思,並能逐步落實於現代醫療服務體系。新世紀當我們眼見醫學科學 醫療技術和醫務管理在不斷突飛猛進的當中,雖然如同回顧歷史的演變一般,

仍舊伴隨有醫療照護環境的異動,但是醫學若要能繼續貢獻於增進人類的福祉,

絕對不可以失去起初的愛心。人有生命,就擺脫不了生老病死的苦痛,醫療是人 類面對生命尋求,而可以用為幫助解除生老病死所帶來苦痛的途徑。因此,期望 能將在安寧緩和療護建構模式的思考和學習當中,所獲得的體認,透過醫學教 育落實於醫療從業人員養成訓練,使這個領域未來加入的新血輪,在面對大環 境的巨變洪流,能堅持投身醫界的抱負與理想、以免陷入凡事利益思考的泥沼,

也許對未來的醫療吾人才能有更多的期待。

英文摘要

The highly developments of modern technology has definitely brought into hospitals lots of related equipments. Not only medical equipments have been accepted and used clinically, but also did computer systems have become important communication

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tools in consideration of administrational management and clinical operation costs.

However, overall, the quality and quantity of direct contact has deteriorated no matter to patient and his family, or to people working for the hospital on the interpersonal interaction. This has caused negative effect on the implementation and enforcement of full medical service that meets human requirement. In view of modern service-

oriented medical management, it is necessary to think about how to keep our care of people and to provide full medical care.

Different to traditional medicine, Hospice Palliative Care focuses on special attention to terminal patient and his family. During the whole process, the patient has his own will. His family can also take part in the whole process to meet the demand of the patient and his family physically, emotionally, socially, and spiritually. It is kind of full attention to promote the living quality of terminal patient and his family. Since National Health Insurance(NHI)started on March 1, 1995, the medical systems have entered a new era. It has not only changed financial structure of medical care, but also has a redistribution of medical resources. It also has a great influence on the civil medical demand, the operation of medical supply system, and service of medical workers.

Facing the changes and impacts of modern medicine, this article would like to build up a bridge between science and humanity through the retrospection of medical history in Taiwan, which will foster humanistic education. Furthermore to analyze the problems encountered form the point of view and model of Hospice Palliative Care, we can provide introspection of medical humanity appeal on the innovation of modern medical system, the education of medical employees, and the build-up of medical teams. Gradually, we will be able to consolidate the system of modern medical service.

Along with rapid improvements on medical science, medical technology and medical management at the new century, there will be changes of environment concerning medical care as well in retrospection of historical development. If we would like medical science to contribute to the welfare of mankind, we cannot lose our original love of people. It is inevitable to live with the pain of birth, aging, illness, and death since we are human. Medicine is the best way to help relieve people from the pain of birth, aging, illness, and death. Hopefully, we can carry out what we learned from the construction of Hospice Palliative Care model in the training of medical employees by medical education. In this way, we can encourage our new bloods in the field, facing the changes of environments, to insist on their goals and ideals, and to prevent from self-interest thinking. Maybe, we can therefore have more expectations on the future of medicine.

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