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关于照顾自杀癌症患者的医护人员对话:患者、其家人及护理人员面临的社会心理问题

A staff dialogue on caring for a cancer patient who commits suicide: psychosocial issues faced by patients, their families, and caregivers.

作者信息

O'Shea E M, Lintz K C, Penson R T, Seiden M V, Chabner B A, Lynch T J

机构信息

Hematology-Oncology Department, Massachusetts General Hospital Cancer Center, Boston, Massachusetts 02114-2617, USA.

出版信息

Oncologist. 1999;4(2):122-7.

Abstract

Shortly before his death in 1995, Kenneth B. Schwartz, a cancer patient at Massachusetts General Hospital (MGH), founded The Kenneth B. Schwartz Center at MGH. The Schwartz Center is a non-profit organization dedicated to supporting and advancing compassionate health care delivery which provides hope to the patient, support to caregivers, and encourages the healing process. The Center sponsors the Schwartz Center Rounds, a monthly multidisciplinary forum during which caregivers discuss a specific cancer patient, reflect on the important psychosocial issues faced by patients, their families, and their caregivers, and gain insight and support from their fellow staff members. The case presented was of a 31-year-old man who developed adenocarcinoma of the lung with painful bone metastases. His tumor was unresponsive to treatment and he subsequently committed suicide by shooting himself. The verbatim and subsequent discussion raised a number of issues. Staff were devastated by the violent way that he ended his life. They questioned whether more could have been done to prevent this outcome, yet acknowledged that it mirrored the way he had lived, and were able to discuss the values by which we live and die. Some, but not all, felt that the patient had the right to choose how and when to end his life.

摘要

1995年,马萨诸塞州总医院(MGH)的癌症患者肯尼斯·B·施瓦茨在去世前不久,在MGH成立了肯尼斯·B·施瓦茨中心。施瓦茨中心是一个非营利组织,致力于支持和推进富有同情心的医疗服务,为患者提供希望,为护理人员提供支持,并促进康复进程。该中心主办施瓦茨中心研讨会,这是一个每月举行的多学科论坛,护理人员在此讨论特定的癌症患者,反思患者、其家人和护理人员所面临的重要社会心理问题,并从同事那里获得见解和支持。所呈现的病例是一名31岁的男子,他患上了伴有疼痛性骨转移的肺腺癌。他的肿瘤对治疗无反应,随后他开枪自杀。逐字记录及随后的讨论提出了一些问题。工作人员对他结束生命的暴力方式感到震惊。他们质疑是否本可以采取更多措施来避免这种结果,但也承认这反映了他的生活方式,并且能够讨论我们生存和死亡所依据的价值观。一些人(但不是所有人)认为患者有权选择如何以及何时结束自己的生命。

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