Beck D, Kettler D
Zentrum Anaesthesiologie, Rettungs- und Intensivmedizin, Georg-August-Universität Göttingen.
Zentralbl Chir. 1998;123(6):624-31.
Traditional medical treatment approaches for incurably and terminally ill persons are often felt by the patients and their families to be lacking, since distressing physical and spiritual symptoms of the disease cannot be adequately addressed. In many cases, care in the final stage of life represents a complex medical challenge whose objective is to maintain an individually sufficient quality of life for the patient. New strategies for therapy and care evolving out of the international hospice movement have entered medical training programs under the heading of palliative medicine. Although palliative medicine has only recently enjoyed increasing acceptance in professional as well as lay circles in Germany, it is widespread in many Anglo-Saxon countries, where it also is offered as an academic discipline in research and teaching. According to the most recent American legal interpretations, palliative treatment has been approved as a constitutional right for patients with severely debilitating symptoms. Against the background of sweeping social restructuring, demographic and tumor-epidemiological developments are exerting increasing pressure on our modern societies to improve treatment approaches for incurable patients. In the public itself a changed and more open treatment of the topics of death and dying is becoming apparent, resulting in a demand as well for medical treatment options. From all this, as well as the fact that Germany has been strongly hesitant to establish palliative medicine facilities, it is apparent that there is a clear need to catch up in the area of palliative medicine treatment, research and teaching. The current mood of fiscal restraint in health care may delay medical progress, but it will not be able to prevent it.
对于身患绝症和处于晚期的患者而言，传统的医疗治疗方法常常让患者及其家属觉得有所欠缺，因为疾病带来的令人痛苦的身体和精神症状无法得到充分解决。在许多情况下，临终关怀是一项复杂的医疗挑战，其目标是为患者维持个人足够的生活质量。源自国际临终关怀运动的新治疗和护理策略已以姑息医学的名义进入医学培训项目。尽管姑息医学最近才在德国的专业人士和普通民众中越来越被接受，但它在许多盎格鲁-撒克逊国家很普遍，在这些国家它还作为一门学术学科用于研究和教学。根据美国最新的法律解释，姑息治疗已被批准为患有严重衰弱症状患者的一项宪法权利。在大规模社会结构调整的背景下，人口结构和肿瘤流行病学的发展给我们现代社会带来越来越大的压力，要求改善对绝症患者的治疗方法。在公众自身中，对死亡和临终话题的态度转变以及更加开放的态度正在显现，这也导致了对医疗治疗选择的需求。鉴于所有这些情况，以及德国在建立姑息医学设施方面一直非常犹豫不决这一事实，显然在姑息医学治疗、研究和教学领域有明显的追赶需求。当前医疗保健领域财政紧缩的形势可能会延缓医学进步，但无法阻止其发展。
