Schuchter Patrick, Heller Andreas
Faculty of Interdisciplinary Studies IFF Wien/Vienna, Institute of Palliative Care and Organisational Ethics, Alpen-Adria University Klagenfurt, Wien, Graz, Austria.
BMJ Support Palliat Care. 2015 Apr;5 Suppl 1:A16-7. doi: 10.1136/bmjspcare-2015-000906.52.
The "basic action" in creating compassionate communities is to create settings where people effectively have the opportunity to develop concerns and compassion for each other. The project "ethics from the bottom up" (in Bad Bentheim, Lower Saxony, Germany) brings together the relatives of old and dying people, professionals from healthcare organisations and people from other living and working contexts in order to share their sorrows and care experiences.
Current methods and concepts of applied and organised ethical deliberation (or ethics "consultation") are not qualified and able to fulfil the requirements of ethical questions in the field of health promotion and health promoting palliative care. The predominant model of ethical deliberation in healthcare settings, the clinical ethics consultation, is designed for the specific orientation needs of curative medicine. The analogous step from medicine to health promotion, from professional palliative care to compassionate communities has not been carried out in ethics. By promoting a compassionate community through shared narratives of care and concern, a paradigmatic shift from clinical ethics to "communal" ethics is put into action.
Participatory action research design. Ethical approach based on narrative and care ethics.
We observe a new and simple way to bring relatives into communication with each other and with professional and (specialised) health services and to discuss the fundamental questions of human life. This is one way of initiating the democratisation of care, of finding support in the challenges of weakness and dying.
In contrast to a narrowing tendency in modern ethics/ethics consultation (focus on moral dilemmas and treatment decisions) the objective of ethical deliberation is not just a singular decision but the sustainable cultivation of collective practical wisdom in a web of meaningful relationships.
创建富有同情心的社区的“基本行动”是营造一种环境，让人们切实有机会培养对彼此的关切和同情。“自下而上的伦理”项目（位于德国下萨克森州的巴特本特海姆）汇聚了老年人和垂危者的亲属、医疗保健机构的专业人员以及来自其他生活和工作环境的人们，以便分享他们的悲伤和护理经历。
当前应用和组织伦理审议（或伦理“咨询”）的方法和概念并不符合且无法满足健康促进和促进健康的姑息治疗领域伦理问题的要求。医疗环境中伦理审议的主要模式——临床伦理咨询，是为治疗医学的特定导向需求而设计的。在伦理领域，从医学到健康促进、从专业姑息治疗到富有同情心的社区这一类似的转变尚未实现。通过分享护理和关切的故事来促进富有同情心的社区，实现了从临床伦理到“社区”伦理的范式转变。
参与式行动研究设计。基于叙事和关怀伦理的伦理方法。
我们观察到一种新的、简单的方式，能让亲属相互之间以及与专业和（专门的）健康服务机构进行交流，并讨论人类生活的基本问题。这是启动护理民主化、在虚弱和死亡的挑战中寻求支持的一种方式。
与现代伦理/伦理咨询中日益狭隘的趋势（专注于道德困境和治疗决策）不同，伦理审议的目标不仅仅是做出单一决策，而是在有意义的关系网络中持续培育集体实践智慧。
