Deodhar Jayita K
MD (Psych), DPM, DNB (Psych), MRCPsych. Associate Professor, Tata Memorial Hospital, Parel, Mumbai, Maharashtra, India.
Mens Sana Monogr. 2016 Jan-Dec;14(1):152-170. doi: 10.4103/0973-1229.193077.
Although 80% of the deaths worldwide occur in middle- and low-income countries such as India, there is less awareness of end-of-life care (EOLC) for people with chronic, serious, progressive, or advanced life-limiting illnesses, including dementia. EOLC involves good communication, clinical decision-making, liaison with medical teams and families, comprehensive assessment of and specialized interventions for physical, psychological, spiritual, and social needs of patients and their caregivers. The psychiatrist can play a significant role in each of the above domains in EOLC. The current trends in India are examined, including ambiguities between EOLC and euthanasia. Future directions include formulating a national EOLC policy, providing appropriate services and training. The psychiatrist should get involved in this process, with major responsibilities in providing good quality EOLC for patients with both life-limiting physical illnesses and severe mental disorders, supporting their caregivers, and ensuring dignity in death.
尽管全球80%的死亡发生在印度等中低收入国家，但对于患有慢性、严重、进行性或晚期危及生命疾病（包括痴呆症）的患者，临终关怀（EOLC）的认知度较低。临终关怀包括良好的沟通、临床决策、与医疗团队及家属的联络、对患者及其护理人员的身体、心理、精神和社会需求进行全面评估及专门干预。精神科医生在临终关怀的上述各个领域都可发挥重要作用。本文审视了印度当前的趋势，包括临终关怀与安乐死之间的模糊界定。未来的方向包括制定国家临终关怀政策、提供适当的服务和培训。精神科医生应参与这一过程，主要负责为患有危及生命的身体疾病和严重精神障碍的患者提供高质量的临终关怀，支持他们的护理人员，并确保死亡时的尊严。
