臨牀透析 Vol.28 No.1(9)


特集名 高齢者医療における透析療法の諸問題 2012
題名 終末期医療・ケアの現況と課題
発刊年月 2012年 01月
著者 大平 整爾 札幌北クリニック
【 要旨 】 本稿では,終末期医療・ケアにおいて重要となる12項目を提示し,わが国における現況と今後の問題点を概説した.終末期医療・ケアの可否評価については,the Economist Intelligence Unitが2010年に行った40カ国の結果を紹介した.死は不可避でありながらほとんどの人にとって思いを馳せたくない命題であり続けているが,生命の行く末に自己主張し何事にも自己決定を尊重する現代社会では,自らの「死の過程」や「死」を考察しそれに対する準備や備えが必要となり社会的な義務となる.死への道程を歩むとき人は誰かの助力を必要とするが,「助死者」ともいうべき人を得れば,死への準備・備えは万全に近づく.医療者は助死者の一人となり,患者を援助するよういっそうの努力が望まれる.
Theme Problems Involved with Dialysis Therapy in the Elderly Medicine
Title Current conditions and problems with end-of-life medical care
Author Seiji Ohira Sapporo Kita Clinic
[ Summary ] Twelve topics are presented which will become increasingly important in end-of-life medical care. The current situation with this subject and possible future problems in Japan are also discussed. The results of an evaluation of end-of-life care by the Economist Intelligence Unit in 2010, which included 40 countries, are introduced. Death is inevitable yet continues to be a subject which most people avoid thinking about. In modern societies, with self assertion for life choises and respect for individuals' self determination in all matters, it will become increasingly necessary for them to consider factors related to their own death. The process of dying makes associated preparations, a social obligation. Along the journey to death, some may seek the aid of others, so-called midwives to the dying. With their help, preparations for dying may be accomplished more easily. Medical care givers can be one type of midwife. As a result, we should make increased efforts to be of assistance to these patients.
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