Krishna Lalit Kumar Radha
Department of Palliative Medicine, National Cancer Center Singapore, Singapore, Singapore.
BMJ Case Rep. 2013 Jun 7;2013:bcr2013009264. doi: 10.1136/bcr-2013-009264.
The concept of personhood is critical to the provision of holistic, patient-centred, palliative care yet no common definition of this term exists. Some characterise personhood by the presence of consciousness-related features such as self-awareness while others deem personhood present by virtue of Divine endowment or as a result of one's social relations. Efforts to appropriately delineate this concept come under scrutiny following suggestions that patients rendered deeply and irreversibly unconscious lack personhood and ought to be considered 'dead'. This case report studies the views of a family caring for a deeply sedated terminally ill patient, to appropriately site local views of personhood within the context of sedation at the end of life. The resultant Ring Theory of Personhood dispenses with concerns that personhood is solely dependent upon consciousness and distances sedative treatments of last resort such as continuous deep sedation from euthanasia.
人格的概念对于提供全面的、以患者为中心的姑息治疗至关重要，但目前尚无该术语的通用定义。一些人通过存在诸如自我意识等与意识相关的特征来界定人格，而另一些人则认为人格是由于神的赋予或个人社会关系的结果而存在。在有建议提出深度且不可逆昏迷的患者缺乏人格并应被视为“死亡”之后，对适当界定这一概念的努力受到了审视。本病例报告研究了一个照顾深度镇静的晚期患者的家庭的观点，以便在生命末期镇静的背景下恰当地定位当地对于人格的看法。由此产生的人格环形理论消除了人格仅取决于意识的担忧，并将诸如持续深度镇静等最后的镇静治疗与安乐死区分开来。
