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[魁北克的临终医疗协助:姑息治疗的背景分析与护理实践分析]

[Medical aid in dying in Quebec: Context analysis and analysis of nursing practice in palliative care].

出版信息

Rech Soins Infirm. 2022 Feb 10(147):67-81. doi: 10.3917/rsi.147.0067.

Abstract

Context : Quebec's "medical aid in dying" (MAID) is a medical intervention mostly practiced in palliative care units. MAID results from a deep revolution within Quebec's ethics regarding end-of-life care. However, there is a lack of empirical studies regarding nursing practice within the context of MAID.Aim : To conduct a literature review of legal and scientific data, as well as data from the media, related to the patient experience of nursing practices in palliative care for patients in Quebec who have requested MAID.Methodology : Burn, Grove, and Sutherland's methodology allowed us to extract and analyze six empirical studies from the CINAHL database. We also analyzed 17 media articles and one legal paper that documents the legalization of MAID in Quebec.Results : There has been a strict law governing MAID since 2015, but some major social events and issues have recently allowed for the expansion of the practice. The literature review allowed us to identify two themes : 1). the nature of nursing practice within MAID, and 2). the need for nursing education that addresses the complex aspects of MAID.Discussion and conclusion : We discuss the effects of the domination of the biomedical narrative on MAID and the collapse of Quebec's health system, which both negatively impact nursing practice in the context of MAID.

摘要

背景

魁北克的“临终医疗协助”(MAID)是一种主要在姑息治疗病房实施的医疗干预措施。MAID源于魁北克在临终关怀伦理方面的深刻变革。然而,在MAID背景下,缺乏关于护理实践的实证研究。

目的

对与魁北克申请MAID的姑息治疗患者护理实践的患者体验相关的法律和科学数据以及媒体数据进行文献综述。

方法

Burn、Grove和Sutherland的方法使我们能够从CINAHL数据库中提取并分析六项实证研究。我们还分析了17篇媒体文章和一篇记录魁北克MAID合法化的法律文件。

结果

自2015年以来,已有一项严格的法律管理MAID,但最近一些重大社会事件和问题使得该实践得以扩展。文献综述使我们能够确定两个主题:1)MAID中护理实践的性质,以及2)对涉及MAID复杂方面的护理教育的需求。

讨论与结论

我们讨论了生物医学叙事的主导地位对MAID的影响以及魁北克卫生系统的崩溃,这两者在MAID背景下均对护理实践产生负面影响。

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