Mahon Margaret M, Sorrell Jeanne M
College of Health & Human Services, George Mason University, Fairfax, Virgina 22030, USA.
Nurs Philos. 2008 Apr;9(2):110-20. doi: 10.1111/j.1466-769X.2008.00344.x.
The task of aligning the philosophical and clinical perspectives on ethics is a challenging one. Clinical practice informs philosophy, not merely by supplying cases, but through shaping and testing philosophical concepts in the reality of the clinical world. In this paper we explore several aspects of the relationship between the philosophical and the clinical within a framework of palliative care for people living with Alzheimer's disease. We suggest that health professionals have a moral obligation to question previous assumptions concerning the quality of life among people with Alzheimer's, and to address the question: does the concept of palliative care properly embrace people with severe dementia? We propose an ethic of palliative care for people with Alzheimer's that is based, not on the traditionally understood principle of autonomy, but on the need to listen to those living with the disease, acknowledging their profound loss of cognitive abilities, with a focus on preventing and relieving suffering, and improving the individual's quality of life.
协调伦理学的哲学视角与临床视角是一项具有挑战性的任务。临床实践为哲学提供信息，不仅是通过提供案例，还通过在临床现实中塑造和检验哲学概念。在本文中，我们在为阿尔茨海默病患者提供姑息治疗的框架内探讨哲学与临床之间关系的几个方面。我们认为，健康专业人员有道德义务质疑先前关于阿尔茨海默病患者生活质量的假设，并解决这个问题：姑息治疗的概念是否恰当地涵盖了重度痴呆患者？我们提出一种针对阿尔茨海默病患者的姑息治疗伦理，它不是基于传统理解的自主原则，而是基于倾听患者的需要，承认他们认知能力的严重丧失，专注于预防和减轻痛苦，并提高个人生活质量。
