Metzger Gaudenz Urs
Department of Design, Trends & Identity, Zurich University of the Arts, Pfingstweidstrasse 96, 8005 Zurich, Switzerland.
Palliat Care Soc Pract. 2023 Mar 31;17:26323524231156943. doi: 10.1177/26323524231156943. eCollection 2023.
Over the past two decades, a debate has arisen concerning the history and philosophy of hospice and palliative care. This critical essay extends this debate by linking the analysis of Dame Cicely Saunders' writings with the concept of worldview, exploring the modern hospice movement vis-à-vis Saunders' approach to terminal care. Worldviews as cultural classifications of reality provide groups and individuals with meaning to navigate everyday and liminal situations. Using this concept in connection to the discipline of the sociology of knowledge, it is possible to grasp how the origins and principles of modern hospice care, from which current palliative care practices evolved, relate to the sociocultural environment of the postwar era in the West. The analysis focuses on a selected body of Saunders' writings, mainly written in the 1960s and 1970s, and discusses different components and functions of her revolutionary care paradigm. In this essay, I show that Saunders' vision of hospice care entails much more than a set of health care practices; it is a complex construct of knowledge and ideas that offers distinct procedures to shelter the dying from pain and loss of meaning. Her vision builds on medical advances and incorporates norms and attitudes related to secularised Protestant and New Age culture, which fostered privatised types of religion and individualistic ideologies and theodicies.
在过去二十年里,围绕临终关怀与姑息治疗的历史和哲学产生了一场争论。这篇批判性文章通过将对西塞莉·桑德斯女爵士著作的分析与世界观概念相联系,拓展了这场争论,探讨了现代临终关怀运动相对于桑德斯的临终护理方法。世界观作为对现实的文化分类,为群体和个人在日常和临界情境中提供了指引方向的意义。将这一概念与知识社会学学科联系起来,就有可能理解现代临终关怀护理的起源和原则(当前的姑息治疗实践即由此演变而来)与西方战后社会文化环境之间的关系。分析聚焦于桑德斯在20世纪60年代和70年代撰写的一批特定著作,并讨论了她那具有革命性的护理范式的不同组成部分和功能。在本文中,我表明桑德斯的临终关怀护理愿景所包含的远不止一套医疗保健实践;它是一个由知识和观念构成的复杂体系,提供了独特的程序,以保护临终者免受痛苦和意义丧失之苦。她的愿景建立在医学进步的基础之上,并融入了与世俗化新教和新时代文化相关的规范和态度,这些文化催生了私有化的宗教类型以及个人主义意识形态和神义论。