Institute for Biomedical Ethics, University of Basel, Switzerland. kathrin.ohnsorge@unibas
Nurs Ethics. 2012 Sep;19(5):629-41. doi: 10.1177/0969733011436206.
Health-care professionals in end-of-life care are frequently confronted with patients who seem to be 'ambivalent' about treatment decisions, especially if they express a wish to die. This article investigates this phenomenon by analysing two case stories based on narrative interviews with two patients and their caregivers. First, we argue that a respectful approach to patients requires acknowledging that coexistence of opposing wishes can be part of authentic, multi-layered experiences and moral understandings at the end of life. Second, caregivers need to understand when contradictory statements point to tensions in a patient's moral experience that require support. Third, caregivers should be careful not to negatively label or even pathologize seemingly contradictory patient statements.
临终关怀专业人员经常会遇到对治疗决策似乎“矛盾”的患者，尤其是当他们表达想死的愿望时。本文通过对两名患者及其护理人员的叙事访谈进行分析，探讨了这一现象。首先，我们认为，对患者的尊重要求承认，相互矛盾的愿望共存可能是生命末期真实、多层次的体验和道德理解的一部分。其次，护理人员需要了解当矛盾的陈述指向患者的道德体验中的紧张时，需要给予支持。第三，护理人员应注意不要对看似矛盾的患者陈述进行负面标记甚至病理化。
