Luptak Marilyn
School of Social Work, University of Minnesota, 105 Peters Hall, 1404 Gortner Avenue, St. Paul, MN 55108, USA.
Health Soc Work. 2004 Feb;29(1):7-15. doi: 10.1093/hsw/29.1.7.
End-of-life issues became increasingly complicated during the 20th century as profound shifts occurred in who died, how they died, and when they died. This article reviews societal changes related to death in the United States and chronicles the developments in social work practice with and for dying people and their families in the 20th century, leading up to the 1993 policy statement of the National Association of Social Workers on end-of-life decision making, which reinforced that client self-determination, a fundamental principle of social work, should apply to people planning for their deaths or undergoing a dying process. After identifying limitations in policies and practices, suggestions are offered to promote competent social work practice and enhance end-of-life care, particularly with reference to the dying process of older people.
在20世纪，随着死亡人群、死亡方式和死亡时间发生深刻变化，临终问题变得日益复杂。本文回顾了美国与死亡相关的社会变革，并记录了20世纪社会工作针对临终者及其家人开展的实践发展历程，直至1993年全国社会工作者协会关于临终决策的政策声明，该声明强化了社会工作的一项基本原则——服务对象自决，应适用于为死亡做准备或正在经历临终过程的人群。在指出政策和实践中的局限性后，本文提出了一些建议，以促进专业的社会工作实践并加强临终关怀，特别是针对老年人的临终过程。
