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临终亲人该不该插鼻胃管的再省思
A Serious Re-consideration Towards Intubating Dying Loved Ones
我很坦白地说，大多数医护人员及医疗团队只是看到与关心“医疗”层面的问题，而我看到与关心的是“医疗”层面背后之“灵性生命”层次的问题。
I am honest to tell that what most of the medical staff see and care is only the medical treatment. What I see and care is the spiritual needs beyond those medical treatment.
在妈妈往生的十年前，我就开始关注妈妈的老化情况，俗话说“母子连心”，我怎么会不知道妈妈的需要！我会在接下来的讨论中清楚地说明。《大学》有云“物有本末，事有始终，知所先后，则近道矣。”在此，我必须先点出“医疗抉择问题”背后的“根本问题”－－也就是我们每一个人的“生命观”与“生死观”，才是所有医疗抉择“思维”与“行为”背后的“根本问题”之所在。如果这个根本问题不先解决，那么当我们不得不面临亲人“生死大事”的“关键时刻”，所有的“医疗抉择”往往都会陷入“进退维谷”的两难与“作茧自缚”的困境。
I began to pay attention to my mother's aging situation ten years before she passed on. As folksay "the hearts of both mother and child are strongly connected", how could I do not understand what my mother needed? I will clearly explain in the following discussion. <Da Xue> quoted "Every object has its begining and ending, if you understand its sequence, you understand the fundamental truth."I would like to point out the fundamental problem which causes problem while making medical decision. That is our own perspective towards life and death. This individually different prespective is the main cause for everyone to think and make decision differently. If we do not solve this disagreement among family members, we have to face great dilemma when our loved ones is in the very "critical moment".
I began to pay attention to my mother's aging situation ten years before she passed on. As folksay "the hearts of both mother and child are strongly connected", how could I do not understand what my mother needed? I will clearly explain in the following discussion. <Da Xue> quoted "Every object has its begining and ending, if you understand its sequence, you understand the fundamental truth."I would like to point out the fundamental problem which causes problem while making medical decision. That is our own perspective towards life and death. This individually different prespective is the main cause for everyone to think and make decision differently. If we do not solve this disagreement among family members, we have to face great dilemma when our loved ones is in the very "critical moment".
当我们不得不面对亲人临终的肉体生命极限时，加上医疗措施也已经到达科技的极限时，就不应该消耗亲人的精神及体力去对抗病魔，或者无谓地拖延其病体的生命，而是应该帮助亲人保留最后的精神及体力，让亲人好好地“活着”准备“往生”。这时家人最应该做的事，就是排除所有不当的医疗干扰，全心全意地“陪伴，照顾”临终亲人。
When we have to face the "departure" of our loved ones, and when all the possible medical measures have reached their limits, we should not consume his physical energy to fight against the disease, or unneccessarily "prolong" his life. What we need to do is to help him to retain the very last physical strength, so that he can pass on peacefully. The most important thing for the family members to do is to eliminate all the improper medical interventions and whole-heartedly accompanying and looking after their dying loved ones.
有一次我和莲花基金会董事长陈荣基教授谈论临终关怀的问题时，他引述台大医院柯文哲医师的话：在加护病房里的末期病人，家里越是有钱，有权，有势的，越是不得好死。为什么？因为越是家大业大的临终病人，他的家人越不舍得让他走，他会越有可能受尽现代先进医疗措施极致的“照顾”－－说得更坦白一点，比较像是“大刑伺候”，在绝大多数的情况下，家属一定会要求“急救加抢救”，一直救到救不了为止，根本就没有机会善终。
When I was having discussion about hospice care with Lotus Foundation Chairman Professor Chen Rong Ji, he quoted words from Doctor Ke Wen Zhe from National Taiwan University Hospital: For those terminally ill patients in ICU, the richer ones tend to not able to have good death. Why? That is because the richer they are, their family members are more prefer to "prolong" their life as much as they can with all possible available modern medical treatments and measures. To be frank, it is more like a great punishment to the patients. In vast majority cases, the family members will request doctor to carry out "urgent and emergency rescue", until the last resort is no longer working, ended up those patients were not given a chance to have good death at all.
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