【摘要】 自《安宁疗护实践指南(试行)》和《安宁疗护中心基本标准和管理规范(试行)》发布以来,国内多家医疗机构、护理院、养老院纷纷建立了安宁疗护病区或病床,安宁疗护事业进入了新的发展阶段。由于理论和实践经验不足,服务中存在着概念不清、重心不明等问题,包括将安宁疗护等同于缓和医疗、关注护理而非治疗、重心理轻生理等认识误区,且面临着传统医疗模式与安宁疗护理念冲突,病情保密与患者知情、家庭决策与患者自主等伦理困境。文章针对晚期肿瘤患者安宁疗护实践中的一些认识误区和伦理困境进行了阐释,并提出了相应的对策。更多还原

【Abstract】 Since the publication of the "Guidelines for the Practice of Hospice Care(for Trial Implementation)"and the"Basic Standards and Management specification for the Hospice Care Center(for Trial Implementation)",many medical institutions and nursing homes in China have established hospice care units or onwards. The establishment of hospice care has entered a new phase. Due to insufficient theoretical and practical experience,there are many problems such as unclear concepts and uncertain concerns in the service,including equating hospice care with palliative care,paying attention to care rather than treatment,focusing on mental rather than physiology,and other misunderstandings. Moreover,there are many ethical dilemmas in the process of service such as the conflicts between traditional medical models and hospice care concepts,confidentiality and informed understanding,family decision-making and patient autonomy. This paper unravels some misunderstandings and ethical dilemmas in the practice of hospice care for patients with advanced tumor,and proposes corresponding countermeasures.更多还原