晚期癌症与安乐死的探讨

对136例无救治希望的晚期癌症患者及家属进行问答式调查,旨在分析安乐死在晚期癌症患者中实施的可行性.结果,只有2.2%的患者欲选择安乐死,家属均不选择安乐死;95.6%的患者和97.8%的家属选择临终关怀或姑息治疗.因此,安乐死难以为人们所接受.     

晚期癌症患者生存质量评估体系建立及放弃治疗与安乐死的合法化

癌症的病因涉及一系列不同的基因和引起突变的各种遗传和环境因素.其发病的内在因素是细胞内的病毒感染或由于原癌基因突变产生的活跃癌基因.环境致癌论已普遍被人关注.癌症村是环境因素所致的一种群体疾病现象.晚期癌症患者的生存质量令人堪忧.切合晚期癌症患者生命意义治疗的研究越来越显示出其价值.医生有权对癌症晚期患者进行生存质量评估后做出放弃治疗的医嘱.建立一套完善的生存质量评估体系是临床决策放弃治疗和合法化安乐死的前提.正确而适当的临床放弃治疗和合法化安乐死是人性化选择的需要.     

患者家属对Ⅳ期非小细胞肺癌患者安乐死的认知调查

对2018年1月～12月广州医科大学附属顺德医院呼吸内科收治的Ⅳ期非小细胞肺癌患者家属148例进行问卷调查。其中有66.67%受访者愿意为患者进行安乐死,有56.02%受访者认为实施安乐死的目的最主要是减轻患者的痛苦。影响安乐死的意愿与宗教背景、安乐死的相关知识、减轻患者的痛苦、对患者本人的权利和意愿尊重、减少经济负担、节约医疗资源等因素有显著关联(P0.05)。目前影响安乐死未能够合法化与传统文化、法律体系、患者及其家属意愿不同、违背医务人员救死扶伤价值观、不利于人类科技和人文精神的进步等因素有显著关联(P0.05)。人们对晚期肺癌患者安乐死的认同态度有所上升,但我国实施安乐死仍缺乏基础。     

晚期癌症患者家属的病情告知态度探究

本文采用自行设计的调查问卷,对200例晚期癌症患者家属进行问卷调查,以探讨晚期癌症患者家属对病情告知的态度。结果显示,认为病情应绝对保密者55例（27．5％）;暂时保密者107例（53．5%）;而不保密者38例（19．0％）。晚期癌症患者家属普遍采取“慈悲原则”,对患者病情持保密态度;癌症患者家属普遍缺乏病情告知策略。临床医生在执行知情同意时应该依据患者不同的家庭情况,有针对性地进行告知。     

癌症患者家属选择是否告知患者真实病情的质性研究

在东方或发展中国家,家庭成员得了癌症后,家属通常反对告知患者真实病情。本研究运用质性研究方法对15例癌症患者家属进行深入访谈,探讨癌症患者家属选择是否告知患者真实病情的原因,以其为临床医护人员正确处理癌症病情告知问题提供指导。     

晚期癌症患者治疗决策的思考

现代医疗尚无法治愈所有晚期癌症。现实与期望之间的较大差距,挑战晚期癌症治疗的临床决策。WHO强调为防止资源滥用,应确保抗癌治疗只用于可获益阶段。对于晚期癌症患者的治疗决策,除遵循规矩原则和循证医学证据原则外,还应该遵循尊重患者意愿、社会公平的美德原则。大多数癌症患者需要接受姑息治疗。姑息治疗为患者及家属提供既简便又经济的医疗服务。     

1例晚期肿瘤患者宁养服务浅谈

通过提供居家宁养护理指导和心理疏导的方法,为晚期癌症患者提供身、心、灵全方位的照顾,从而提高晚期癌症患者的生活质量。通过对1例晚期肿瘤患者进行症状控制、护理指导、心理疏导、灵性沟通,该晚期肿瘤患者及家属的自身照顾能力提高,晚期肿瘤患者在生命末期的生活质量有所提高,最终达到善终。身心灵的照顾在宁养服务中起重要作用,有利于患者生活质量的提高,但仍要根据患者的个体特点并掌握一定技巧。     

肿瘤临终关怀中的家属辞世教育

晚期癌症患者的家属在临终家居照顾及医院宁养照顾中起到重要的作用,对临终患者家属的关怀照顾是临终关怀的重要组成部分,通过从家属心理特点、影响家属心理的因素、家属辞世教育方法三个方面具体阐述在家属辞世教育的工作步骤,从而更好的指导社会医疗实践,促进临终关怀工作在我国的发展.     

叙事医学视角下的临终关怀研究

通过对临终个体照顾者的经历进行叙述,尝试通过"叙事医学"实践深入认识、吸收、解释和回应临终个体照顾者的故事,聆听临终个体照顾者被科学话语所排斥的声音,通过交流加强临终个体照顾者的优质体验。关注癌症晚期病人家属的问题。基于对癌症临终病人家属的深度访谈后发现,对这些个体经历分析发现,癌症晚期病人家属经历了5个阶段的哀伤旅程:宣判癌症晚期、癌症病人的病情告知、临近死亡、亲人死亡、复杂的哀伤。     

肿瘤临终关怀中的家属辞世教育

晚期癌症患者的家属在临终家居照顾及医院宁养照顾中起到重要的作用，对临终患者家属的关怀照顾是临终关怀的重要组成部分，通过从家属理特点、影响家属心理的因素、家属辞世教育方法三个方面具体阐述在家属辞世教育的工作步骤，从而更好的指导社会医疗实践，促进临终关怀工作在我国的发展。     

Traditional God Images and Attitudes Towards Voluntary Euthanasia

I use data from the General Social Survey (N = 8905) to evaluate whether imagining God in traditional ways is associated with attitudes towards voluntary euthanasia. Bivariate analysis reveals that individuals who imagine God as a father, a master, and a king have negative attitudes towards voluntary euthanasia. The associations between imagining God as a father and as a master and attitudes towards voluntary euthanasia hold after controlling for religious affiliation, frequency of religious attendance, views of the Bible, and other sociodemographic characteristics that predict attitudes towards voluntary euthanasia; however, the association between imagining God as a king do not. I also find that while there is no association between imagining God as a judge on voluntary euthanasia attitudes at the bivariate level, there is a significant and positive association with having favorable voluntary euthanasia attitudes in the full model, revealing a suppression effect. These findings highlight the importance of evaluating if different, distinct beliefs about the same religious object have differential associations with social attitudes and behaviors.     

安乐死是何种权利?——关于安乐死的法伦理学解读

安乐死是能为人们带来人格利益的道德权利。我们没有合理的理由对其做出限制 ,但它却很难成为一种法定的权利。主要的阻碍是立法的客观条件不具备 ,以及法律天生的对人性的忧虑。这意味着 ,安乐死作为一种应有的权利要转化为法定权利 ,尽管不是没有可能 ,但要有十分的耐心和谨慎。     

中国安乐死倡议与"道德陷阱"

针对目前我国公众中普遍认同的安乐死倡议,对于信息的误读、狭隘的感性同情或者不适用的理性经济学逻辑、对于现实社会保障有效供给严重不足的忽视,构成了现阶段安乐死倡议背后的"道德陷阱".     

After the slippery slope: Dutch experiences on regulating active euthanasia

"When a country legalizes active euthanasia, it puts itself on a slippery slope from where it may well go further downward." If true, this is a forceful argument in the battle of those who try to prevent euthanasia from becoming legal. The force of any slippery slope argument, however, is by definition limited by its reference to future developments which cannot empirically be sustained. Experience in the Netherlands--where a law regulating active euthanasia was accepted in April 2001--may shed light on the strengths as well as the weaknesses of the slippery slope argument in the context of the euthanasia debate. This paper consists of three parts. First, it clarifies the Dutch legislation on euthanasia and explains the cultural context in which it originated. Second, it looks at the argument of the slippery slope. A logical and an empirical version are distinguished, and the latter, though philosophically less interesting, proves to be most relevant in the discussion on euthanasia. Thirdly, it addresses the question whether Dutch experiences in the process of legalizing euthanasia justify the fear of the slippery slope. The conclusion is that Dutch experiences justify some caution.     

Euthanasia and the Slippery Slope

Although those with liberal attitudes towards voluntary euthanasia are often castigated as crude consequentialists who give overriding value to social utility, two common arguments against permitting active voluntary euthanasia even in the most desperate of cases, the slippery-slope argument and the argument that further research into terminal care and pain control will be discouraged, are entirely consequentialist, and to invoke them to justify withholding assistance in these desperate cases is to fail to respect patients as ends in themselves.     

Euthanasia and the Distinction Between Acts and Omissions

ABSTRACT It is commonly assumed that the view that passive euthanasia is morally preferable to active euthanasia is an implication of the view that killing someone is worse than merely letting her die, and that it is held by its proponents on this ground. Accordingly, attempts to discredit the former often take the form of attempted refutations of the latter. In the present paper, it is argued that such attempts are misguided, since the former view is not in fact implied by the latter.     

Desire for euthanasia or physician-assisted suicide in palliative cancer care.

OBJECTIVE: To investigate the attitudes of terminally ill individuals toward the legalization of euthanasia or physician-assisted suicide (PAS) and to identify those who would personally desire such a death. DESIGN: In the Canadian National Palliative Care Survey, semistructured interviews were administered to 379 patients who were receiving palliative care for cancer. Patients who expressed a desire for physician-hastened death were followed prospectively. MAIN OUTCOME MEASURES: Attitudes toward the legalization of euthanasia or PAS were determined, as was the personal interest in receiving a hastened death. Demographic and clinical characteristics were also recorded, including a 22-item structured interview of symptoms and concerns. RESULTS: There were 238 participants (62.8%) who believed that euthanasia and/or PAS should be legalized, and 151 (39.8%) who would consider making a future request for a physician-hastened death. However, only 22 (5.8%) reported that, if legally permissible, they would initiate such a request right away, in their current situations. This desire for hastened death was associated with lower religiosity (p=.010), reduced functional status (p=.024), a diagnosis of major depression (p<.001), and greater distress on 12 of 22 individual symptoms and concerns (p<.025). In follow-up interviews with 17 participants, 2 (11.8%) showed instability in their expressed desire. CONCLUSION: Among patients receiving palliative care for cancer, the desire to receive euthanasia or PAS is associated with religious beliefs; functional status; and physical, social, and psychological symptoms and concerns. Although this desire is sometimes transitory, once firmly established, it can be enduring.     

The View of Religions Toward Euthanasia and Extraordinary Treatments in Japan

388 Japanese religious groups—143 Shinto, 157 Buddhist, 58 Christian and 30 others—were asked to answer questions regarding several forms of euthanasia and extraordinary treatment during the dying process. Passive euthanasia and indirect euthanasia were accepted by around 70% of the respondents. Active euthanasia was favored by less than 20% of them. Christians were less supportive of euthanasia than practitioners of other religions. Shinto and Buddhist corporations advocated being natural, when medical treatment became futile at the terminal stage. Religionists' views may deepen the discussion of end-of-life issues.     

Attitude towards euthanasia in relation to death anxiety among a sample of 343 nurses in India

Scores on Attitude towards Euthanasia were correlated with scores on Death Anxiety among 343 female nurses in India using Templer's Death Anxiety Scale and the authors' 24-item attitude scale. No significant correlation was found between the two sets of scores (r = -.09) or a nonlinear score on relation. Age of nurses was not significantly related to Attitude towards Euthanasia (r = .07) or Death Anxiety (r = .11). As measured, death anxiety has no bearing on attitude about euthanasia.