McGrath Pam, Henderson David
International Program of Psycho-Social Health Research, Central Queensland University, Brisbane, Kenmore, Australia.
Am J Hosp Palliat Care. 2008 Jun-Jul;25(3):215-22. doi: 10.1177/1049909108315514. Epub 2008 Jun 6.
Historically palliative care research has focused on issues associated within the hospice and palliative care system. The findings presented in this manuscript reverse this assumption to argue that significant palliative care issues can only be understood if the focus is on the acute care system. Although a major proportion of deaths happen in the acute hospital setting, the acute care clinicians are the gate keepers to the palliative system. In short, understanding the ethical decision making of acute care professionals in relation to end-of-life care can illuminate many important palliative care practice development issues. The findings indicate that all professional groups in this study of an acute medical ward find end-of-life issues the most challenging of all the ethical challenges.
从历史上看，姑息治疗研究一直聚焦于临终关怀和姑息治疗系统相关的问题。本手稿中呈现的研究结果颠覆了这一假设，认为只有将重点放在急性护理系统上，才能理解重大的姑息治疗问题。尽管大部分死亡发生在急性医院环境中，但急性护理临床医生却是姑息治疗系统的把关人。简而言之，了解急性护理专业人员在临终关怀方面的伦理决策，能够阐明许多重要的姑息治疗实践发展问题。研究结果表明，在这项针对急性内科病房的研究中，所有专业群体都认为临终问题是所有伦理挑战中最具挑战性的。
