| 特集名 | 高齢者の透析導入を再考する | |
|---|---|---|
| 題名 | 高齢を生きるための複数の視点 | |
| 発刊年月 | 2016年 01月 | |
| 著者 | 清水 哲郎 | 東京大学大学院人文社会系研究科死生学・応用倫理センター上廣講座 |
| 【 要旨 】 | 高齢者における透析導入等の意思決定プロセスにおいて，複数の視点が並存する状況に注目して次の諸点を考察する．(1) 医療の役割は〈人生〉の展開を目指して〈生命〉を整えることであり，無条件に〈生命〉を維持することがよいわけではない．(2) 人には皆で協働して生きようとする姿勢〈皆一緒〉と，別々に生きようとする姿勢〈人それぞれ〉が並存しており，各人は相手との関係に応じて両姿勢をブレンドしつつ対応している．家族内では〈皆一緒〉が支配的であることに由来して，〈自分〉の場合と〈家族〉の場合とで一見矛盾する言動が結果する．(3) 必要に応じて社会的ケアを受けることが推奨されるが，際限なくケアを受けてよいわけでなく，〈各人の最善〉と〈社会資源の総量〉とを併せ考える必要がある． | |
| Theme | Reconsidering dialysis initiation for the elderly | |
|---|---|---|
| Title | Significant aspects for living one's old age | |
| Author | Tetsuro Shimizu | University of Tokyo, Graduate School of Humanities and Sociology, Uehiro Chair for Death & Life Studies and Practical Ethics |
| [ Summary ] | There are a few significant pairs of aspects occasionally conflicting in the decision-making process, for instance, on whether to receive dialysis. Among them, a pair of aspects, biographical life and biological life, is noteworthy ; the former refers to our life we lead with meaning, while the latter refers to physical life. The role of medical care is to help patients enjoy their biographical life, by medically treating their biological life. A pair of attitudes, live-side-by-side, or mutual support, and live-and-let-live, or mutual non-interference, is also noteworthy as crucial for decision-making ethics. People gauge appropriate behavior by assessing the distance between others and blending the two differing attitudes in proportion to that distance. Particulaly in intra-family relationships, the live-side-by-side attitude is dominant, which results in certain distinctive behaviors. In addition, some people are reluctant to accept social support and think that they should live by themselves, but our society has both live-side-by-side and live-and-let-live attitudes. People are able to strengthen society's attitudes by receiving social support when they need it. Currently, when we plan for our old age regarding health and nursing care, we should consider the amount of social resources our society will be able to offer us. |
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