Black Kathy, Csikai Ellen L
a College of Arts and Sciences , University of South Florida, Sarasota-Manatee , Sarasota , Florida , USA.
J Soc Work End Life Palliat Care. 2015;11(1):27-49. doi: 10.1080/15524256.2015.1021072.
Due to the unprecedented increase in the United States aging demographics, many more people are living longer and reaching older ages than ever before. However, a longer life is not necessarily a better life, as the vast majority will face a period of prolonged deteriorating health prior to death. Although notable efforts have been underway that are designed to improve the end-of-life experience, increasing numbers of individuals express a desire and/or act upon an intent to end their lives precipitously. Though still limited, the options to actively participate in their own deaths are growing. Requests for a hastened death can occur among people of all ages and includes those with advanced illness as well as others wanting to die due to unbearable suffering. This article provides an overview of the ongoing discourse about the experience of dying faced by many older adults, including aspects frequently associated with "a good death." The limitations of established practices which seek to provide a "better" dying experience are identified followed by discussion of the growing availability of alternative options. Reflective considerations are presented to guide practice vis-à-vis the changing landscape surrounding options in dying.
由于美国人口老龄化出现前所未有的增长，比以往任何时候都有更多的人寿命延长且年龄更大。然而，更长的生命不一定是更好的生命，因为绝大多数人在死亡前将面临一段健康状况长期恶化的时期。尽管一直在做出显著努力以改善临终体验，但越来越多的人表达了突然结束生命的愿望和/或付诸行动。虽然积极参与自己死亡的选择仍然有限，但这类选择正在增加。加速死亡的请求可能发生在所有年龄段的人群中，包括患有晚期疾病的人以及因无法忍受的痛苦而想死的其他人。本文概述了关于许多老年人临终体验的持续讨论，包括经常与“善终”相关的方面。确定了旨在提供“更好”临终体验的既定做法的局限性，随后讨论了替代选择的日益增加。提出了反思性的考量，以指导针对临终选择不断变化的情况开展实践。
