Gendeh H S, Bhar A S, Gendeh M K, Yaakup H, Gendeh B S, Kosai N R, Ramzisham A R
Universiti Kebangsaan Malaysia Medical Centre, Head and Neck Surgery, Faculty of Medicine, Department of Othorhinolaryngology, Jalan Yaacob Latif, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Malaysia.
Mercer University, Critical Care and Sleep Medicine, Division of Pulmonary, United States.
Med J Malaysia. 2016 Oct;71(5):259-263.
End of life care is framework to allow for a peaceful, comfortable and dignified death while considering the patients' personal and religious values, bioethics and knowledge of the disease process. A well planned end of life pathway should allow for the flexibility to shift from an active (or aggressive) treatment approach to one of comfort and care when initial interventions have failed. The need for this pathway is most apparent in the intensive care setting. Implementation of a pathway will face various challenges due to religious and cultural beliefs, education of healthcare providers to carry out difficult discussions and larger socioeconomic implications. Clear medico-legal framework will be required to support this pathway. In conclusion, an end of life pathway tailored to our local needs is the way forward in allowing for dignified death of terminally ill patients; this will require the active participation of medical societies, religious leaders, healthcare providers, patients and their care givers.
临终关怀是一个框架,旨在让患者在考虑其个人和宗教价值观、生物伦理以及疾病进程知识的同时,安详、舒适且有尊严地离世。一条精心规划的临终途径应具备灵活性,当初始干预措施失败时,能够从积极(或激进)的治疗方式转变为舒适护理方式。这种途径的需求在重症监护环境中最为明显。由于宗教和文化信仰、医护人员进行艰难讨论的教育以及更大的社会经济影响,实施这样一条途径将面临各种挑战。需要明确的医学法律框架来支持这一途径。总之,根据我们当地需求量身定制的临终途径是让绝症患者有尊严地离世的前进方向;这将需要医学协会、宗教领袖、医护人员、患者及其护理人员的积极参与。