医師の立場から : 在宅ホスピスの考え方(シンポジウム 病とは何か・癒しとは何か,<特集>病とは何か・癒しとは何か インフォームド・コンセントとは何か)

抄録

In modern medicine, diseases are not apt to be dealt with as a whole but only as a part. Illness, which emphasizes a patient as a whole with sufferring, needs cares which bring him a total healing as a man with dignity of life. The definition of the terminal stage of cancer differs from man to man, but the decision should belong to the right of autonomy of the patient himself. Dr. C. Saunders, a founder of modern hospice, described the principles of hospice cares sa follows. Firstly, hospice care should be aimed not to cure but to care which brings the patient comfort. Secondly, palliation should be done only for symptom control, mainly for pain relief. Thirdly, individual care for patient and his family should be devoted. Lastly, the care should be carried out by multidisciplinary care team. Home hospice, which enables the patient to receive hospice service at home, is not the matter of place but it includes an essential problems, namely, whether the patient can keep on the host's position of his own life or not. Domiciliary hospice thus brings about total care for the patient and the family.