Nauck Friedemann
Ther Umsch. 2018 Jul;75(2):112-116. doi: 10.1024/0040-5930/a000975.
Role of the influence of cultural and religious beliefs on medical end-of-life decision-making Abstract. Decision-making at the end of life must encompass medical indication, therapeutic offer, patient autonomy and consent. Furthermore, physicians must reflect on whether their own cultural and religious beliefs have an influence on their decision-making process. Basic knowledge in palliative care or integration of experts in palliative care may be useful when dealing with patients at the end of life, particularly when shifting treatment goals to palliative or comfort care measures is considered or necessary. Expertise in palliative care may also be useful in the care for patients well before the end of life, for example in symptom management, wound care, communication with family or psycho-social care. Ideally, goals of care should be discussed with the patient. Decision-making includes judging, respecting individual values, caring and taking on responsibility - including responsibility for potentially wrong choices. It is imperative that respect for patient autonomy and increasingly strengthened patient competence must be reflected in physicians' reasoning about medical and ethical end-of-life decisions, as well as about empirical and normative aspects of medical indication.
文化和宗教信仰对临终医疗决策的影响作用 摘要。临终决策必须涵盖医学指征、治疗方案、患者自主权及同意。此外，医生必须思考自身的文化和宗教信仰是否会对其决策过程产生影响。在处理临终患者时，姑息治疗的基础知识或整合姑息治疗专家可能会有所帮助，尤其是在考虑或需要将治疗目标转向姑息或舒适护理措施时。姑息治疗方面的专业知识在患者生命末期之前的护理中也可能有用，例如在症状管理、伤口护理、与家属沟通或心理社会护理方面。理想情况下，护理目标应与患者进行讨论。决策包括判断、尊重个人价值观、关怀和承担责任——包括对潜在错误选择的责任。在医生对临终医疗和伦理决策以及医学指征的实证和规范方面进行推理时，必须体现出对患者自主权的尊重以及日益增强的患者能力，这一点至关重要。
