Basile C M
HealthPartners, Spring Lake Park, Minn., USA.
Nurse Pract. 1998 May;23(5):44-6, 54, 57-60.
This article examines the issue of advocacy for all adults in end-of-life decisions to help enhance the role of health care providers as partners in decision making. The ethical issues of death and dying are of particular concern for the elderly. Conflicts may prevent providers and nurses from creating a good dying experience for patients and family. Among the many issues associated with end-of-life decision making are futility, autonomy, and quality of life, a "good death," advance directives, family distress, and the culture of medicine. To overcome related barriers, involved health care providers can promote advocacy by offering choices in end-of-life care and providing an environment of listening and communication. Initiating and maintaining dialogue on this difficult subject will provide better care to patients and families.
本文探讨了在临终决策中为所有成年人提供支持的问题，以帮助增强医疗保健提供者在决策过程中作为合作伙伴的作用。死亡和临终的伦理问题尤其受到老年人的关注。冲突可能会阻碍医疗人员和护士为患者及其家人创造良好的临终体验。与临终决策相关的诸多问题包括医疗的无效性、自主权、生活质量、“善终”、预先指示、家庭困扰以及医学文化。为克服相关障碍，参与其中的医疗保健提供者可以通过在临终护理中提供选择并营造倾听和沟通的环境来促进支持工作。就这个棘手的话题展开并维持对话将为患者及其家人提供更好的护理。
