García-Baquero Merino María Teresa
Facultad de Medicina, Universidad Católica San Antonio de Murcia, Murcia, Spain.
Front Pharmacol. 2018 Oct 16;9:1140. doi: 10.3389/fphar.2018.01140. eCollection 2018.
Our medicalised modern cultures render reason and mystery mutually exclusive, define death by disease as failure, and dying as disgraceful. Providers and policymakers alike marginalize aging and dying individuals, formulating largely ineffective strategies without palliative care and pain relief budgets. The aim of palliative care is to support the person with incurable illness to live their remaining life as well and as meaningfully as possible and to support them as they eventually die from their illness and reaching the natural end of their lives It acknowledges that each life is morally significant, restoring patients' and families' quality of life where possible, and attending meticulously to the dying period as necessary (Saunders, 1965). Hospices are far more than mere buildings; they house an ethos of care. The field is currently challenged by its variable situation over the world and the pressing need to incorporate new technology to its practice. This article provides a review of some important milestones in the history and development of Palliative Care and evolution of Palliative Medicine in some countries, some current issues concerning consistency in its implementation, and some likely prospects for its future advance and expected expansion, from the perspective of one central question: "What constitutes the ethos of Palliative Care replicating its foundational philosophy and principles?" which helps to set the scene for possible future advances to integrate ethical, legal, and social implications. Technology will help expansion by facilitating communication and predicting needs.
我们的医学化现代文化使理性与神秘相互排斥,将因病导致的死亡定义为失败,将濒死视为耻辱。医疗服务提供者和政策制定者都将老年人和濒死个体边缘化,在没有姑息治疗和疼痛缓解预算的情况下制定出大多无效的策略。姑息治疗的目的是支持患有不治之症的人尽可能充实地度过余生,并在他们最终因病去世、生命自然终结时给予支持。它承认每一个生命都具有道德意义,尽可能恢复患者及其家人的生活质量,并在必要时精心照料濒死阶段(桑德斯,1965年)。临终关怀院远不止是建筑物;它们承载着一种关怀精神。目前,该领域面临着全球范围内情况各异的挑战,以及将新技术融入其实践的迫切需求。本文从一个核心问题的角度,回顾了姑息治疗历史与发展中的一些重要里程碑、一些国家姑息医学的演变、当前在实施过程中有关一致性的一些问题,以及其未来发展和预期扩张的一些可能前景:“什么构成了体现其基本理念和原则的姑息治疗精神?”这有助于为整合伦理、法律和社会影响的未来可能进展奠定基础。技术将通过促进沟通和预测需求来助力扩张。