Csikai E L, Bass K
School of Social Work, Stephen F. Austin State University, Nacogdoches, TX 75961, USA.
Soc Work Health Care. 2000;32(2):1-22. doi: 10.1300/j010v32n02_01.
End-of-life care decision making is perhaps the most difficult practice situation faced by health care social workers. Complex ethical issues arise from decisions regarding use of advancing medical technologies and/or other artificial treatments that may prolong life and/or compromise its quality. NASW has set forth a policy to help guide social workers dealing with end-of-life care decisions and the preservation of client self-determination in these situations. However, the present study (N = 63) revealed that a majority (57%) of social workers were not aware of the existence of, or were only somewhat familiar with the policy. Ethical dilemmas most often faced in end-of-life care situations related primarily to issues of communication between and among patients, families, and professionals. Practitioners indicated that more specific practice guidelines and increased education regarding bioethics and issues of end-of-life care are needed to be effective in assisting patients and families in end-of-life decision making.
临终关怀决策可能是医疗保健社会工作者面临的最困难的实践情况。关于使用先进医疗技术和/或其他可能延长生命和/或损害生命质量的人工治疗的决策引发了复杂的伦理问题。美国社会工作者协会已经制定了一项政策，以帮助指导社会工作者处理临终关怀决策以及在这些情况下维护客户的自决权。然而，本研究（N = 63）显示，大多数（57%）社会工作者不知道该政策的存在，或者只是对该政策有些熟悉。临终关怀情况下最常面临的伦理困境主要与患者、家庭和专业人员之间的沟通问题有关。从业者表示，需要更具体的实践指南以及加强关于生物伦理学和临终关怀问题的教育，才能有效地协助患者和家庭进行临终决策。
