Byock Ira R, Corbeil Yvonne J, Goodrich Martha E
Department of Anesthesiology, Dartmouth-Hitchcock Medical Center, Lebanon, NH 03756, USA.
Am J Hosp Palliat Care. 2009 Jun-Jul;26(3):200-8. doi: 10.1177/1049909108328700. Epub 2009 Jan 9.
Despite well-documented deficiencies and widespread suffering experienced by millions of elderly or ill Americans and their families, politicians rarely address end-of-life issues. Citizen Forums in New Hampshire surveyed 463 people regarding aging, serious illness, and caregiving. More than 80% indicated it was very or extremely important to have their dignity respected, preferences honored, pain controlled, and to not leave family with debt. Less than half strongly endorsed being kept alive as long as possible, prayed with or for, or having assisted-suicide available. Over 80% strongly endorsed palliative care requirements clinical licensure and reimbursement, expansion of family caregiver leave, respite care, and bereavement support. By avoiding actions which elicit strong divergence of opinion and focusing on actions on which consensus exists, public officials and candidates can respond to problems and improve care and experience for frail elders, dying Americans, and their families.
尽管数以百万计的美国老年人或患病者及其家人经历了有充分记录的缺陷和广泛的痛苦，但政治家们很少讨论临终问题。新罕布什尔州的公民论坛对463人进行了关于衰老、重病和护理的调查。超过80%的人表示，尊重他们的尊严、尊重他们的偏好、控制疼痛以及不让家人背负债务非常或极其重要。不到一半的人强烈支持尽可能延长生命、有人为之祈祷或有协助自杀的选择。超过80%的人强烈支持姑息治疗的临床许可和报销、扩大家庭护理假、临时护理以及丧亲支持。通过避免引发强烈意见分歧的行动，并专注于存在共识的行动，公职人员和候选人可以应对问题，并改善体弱长者、濒死的美国人及其家人的护理和体验。
