Mattes Malcolm D, Sloane Michelle A
Department of Radiation Oncology, West Virginia University, Morgantown, West Virginia.
University of Pennsylvania, Philadelphia, Pennsylvania.
J Am Geriatr Soc. 2015 May;63(5):993-6. doi: 10.1111/jgs.13392. Epub 2015 May 4.
Physicians caring for individuals with life-altering, incurable illnesses often have a desire to convey a sense of hope while also helping their patients prepare for the end of life to minimize unnecessary suffering and grief. Unfortunately, in the United States, most people receive more-aggressive treatments toward the end of life than studies would suggest that they desire. This reflects the challenging task of balancing optimism and realism, and how providing a false sense of hope for a cure for too long a time while avoiding advance care planning may contribute significantly to the problem. This article explores the interplay of hope and advance care planning, and suggests a need for excellent individualized communication in the setting of advanced cancer to improve end-of-life care.
照顾患有改变生活的不治之症患者的医生，往往希望传达一种希望感，同时帮助患者为生命的终结做好准备，以尽量减少不必要的痛苦和悲伤。不幸的是，在美国，大多数人在生命末期接受的治疗比研究表明他们想要的更加激进。这反映了平衡乐观主义和现实主义这一具有挑战性的任务，以及在过长时间内提供治愈的虚假希望感同时避免提前护理规划可能如何对问题产生重大影响。本文探讨了希望与提前护理规划之间的相互作用，并表明在晚期癌症的情况下需要进行出色的个性化沟通，以改善临终护理。
