Bull Hist Med. 2020;94(2):268-288. doi: 10.1353/bhm.2020.0037.
The American hospice movement arose in the 1970s as an alternative to standard hospital care for terminally ill patients, emphasizing symptom management and psychological and spiritual care. St. Luke's Hospice of New York City was an outlier in this movement. While other hospices sought to distance themselves from the preexisting healthcare system for fear of its corrupting influence, St. Luke's sought to transform the system from within. While other hospices ultimately accommodated state and federal regulations for terminal care, St. Luke's tried to survive outside of this newly regulated space. This examination of St. Luke's Hospice complicates the preexisting narrative of the hospice movement as a countercultural movement that was subsequently corrupted by integration into mainstream healthcare. It also demonstrates opportunities and challenges in trying to change the structure and culture of the acute care hospital.
美国的临终关怀运动兴起于 20 世纪 70 年代，是为绝症患者提供的一种替代标准医院护理的选择，强调症状管理以及心理和精神关怀。纽约市的圣卢克临终关怀医院是这一运动中的异类。其他临终关怀机构担心受到现有医疗保健系统的不良影响而试图与该系统保持距离，而圣卢克临终关怀医院则试图从内部改变该系统。尽管其他临终关怀机构最终还是适应了州和联邦的终末期护理法规，但圣卢克临终关怀医院试图在这个新监管的领域之外生存。对圣卢克临终关怀医院的研究使临终关怀运动作为一种反文化运动的既定叙事变得复杂，这种叙事后来因融入主流医疗保健而受到影响。它还展示了在试图改变急性护理医院的结构和文化方面所面临的机遇和挑战。
