“被判死刑的病房”

你听说过“临终关怀”吗？

就是在生命的最后阶段，给予温暖和关怀。

听起来很致郁？其实不然，它更多的是治愈，是由温暖的谎言编织的与死亡和解的故事。

跟随一名医生的视角，一起去看看临终关怀科每天在发生什么……

为了让老年人过上舒适的生活，有尊严地死去，2015年，国务院办公厅转达的《关于促进医疗和保健服务与老年护理服务相结合的指导意见通知》明确阐述了其目标[12]：

“为老年人提供与治疗相关的住院、康复相关的护理、稳定的生活护理和临终关怀，以提供健康和养老金服务。”

目前，中国有200多家医院和机构提供临终关怀服务。

他们为病人提供住院、社区和家庭临终关怀服务，以确保病人获得身心安慰，帮助家人应对情感的困难[13]。

当一个人无法避免地走向死亡，而任何治疗都无法阻止这一过程，甚至会伤害到病人时。

也许采取不加速也不拖延死亡的姑息疗法，让生命的最后一程走得完满有尊严，是一个更好的选择。

著名的医学顶刊《柳叶刀》曾提到了“死亡素养”一词——它是指人们驾驭死亡所需的知识和技能[14]。

无论身在何处，无论是贫穷还是富有，死亡都是我们无法跨越的结界。

面对亲人的即将离去，当医学束手无策时，我们还能做什么呢？

关怀和陪伴，是此时最有力量的安慰。

再陪他们去花园散散步，听听树梢里鸟儿的鸣叫；

再为他们按摩按摩手脚，传递你手掌的温度；

再和他们说说那些未完待续的故事，留下一份共同的回忆，温暖他们生命的最后一程，也温暖你今后的光阴。

参考文献：

[1] 国家卫生健康委办公厅,国家中医药局办公室. 癌症疼痛诊疗规范(2018年版)[J]. 全科医学临床与教育,2019,17(1):4-8.

[2] Teunissen SC, Wesker W, Kruitwagen C, de Haes HC, Voest EE, de Graeff A. Symptom prevalence in patients with incurable cancer: a systematic review. J Pain Symptom Manage. 2007 Jul;34(1):94-104.

[3] Currow DC, Agar MR, Phillips JL. Role of Hospice Care at the End of Life for People With Cancer. J Clin Oncol. 2020 Mar 20;38(9):937-943.

[4] Seow H, Barbera L, Sutradhar R, et al. Trajectory of performance status and symptom scores for patients with cancer during the last six months of life. J Clin Oncol. 2011 Mar 20;29(9):1151-8.

[5] Johnson MJ, Yorke J, et al. Towards an expert consensus to delineate a clinical syndrome of chronic breathlessness. Eur Respir J. 2017 May 25;49(5):1602277.

[6] Hosie A, Davidson PM, et al. Delirium prevalence, incidence, and implications for screening in specialist palliative care inpatient settings: a systematic review. Palliat Med. 2013 Jun;27(6):486-98.

[7] Ling M, Wang X, Ma Y, Long Y. A Review of the Current State of Hospice Care in China. Curr Oncol Rep. 2020 Jul 28;22(10):99.

[8] National Bureau of Statistics (China). The population grew steadily and the quality of the population improved significantly—The 20th in a Series of Reports on the Achievements of Economic and Social Development on the 70th Anniversary of the Founding of New China. 2019.

[9] Chen WQ, Zheng RS, Baade PD, et al. Cancer statistics in China, 2015. CA Cancer J Clin. 2016;66:115–32.

[10] Qiu H, Cao S, Xu R. Cancer incidence, mortality, and burden in China: a time-trend analysis and comparison with the United States and United Kingdom based on the global epidemiological data released in 2020. Cancer Commun (Lond). 2021 Oct;41(10):1037-1048.

[11] National Cancer Institute at the National Institute of Health (USA). Choices for care when treatment may not be an option.2018. https://www.cancer.gov/about-cancer/advanced-cancer/care-choices#HC. Accessed 12 November 2019.

[12] General Office of the State Council (China). Notice on guiding opinions on promoting the combination of medical and health services and old-age care services. 2015.http://www.gov.cn/zhengce/content/2015-11/20/content_10328.htm. Accessed 12 November 2019.

[13] Li LM, Niu M, Yao CY. Research progress on development model of internet+ hospice care. Nursing Research of China. 2018;32:2676–8.

[14] Sallnow L, Smith R, et al. Report of the Lancet Commission on the Value of Death: bringing death back into life. Lancet. 2022 Feb 26;399(10327):837-884.