Terminal Care and Psychosomatic Medicine(An Overview of Paychosomatic Medicine for 21 at Century-On Treatment)

Abstract

Terminal care involves many problems in the field of psychosomatic medicine and medical psychology. Psychosomatic medicine plays an important role in terminal care, which is now being re-evaluated, as seen in the hospice movement, in response to recent remarkable improvement in medical science and technology and socio-economic changes. In Japan also, the Society for the Study of Dying Patients was launched in 1977 to learn and discuss the problems of dying patients. The Society's main theme is to study how one can live a higher quality of life when one faces remaining days toward death. Today terminal care deals with right to self-determination, treatment approaches such as meaningless prolongation of life or alleviation of symptoms, cure or care, revival and life-saving treatment at the time of death, medical economics, the place to die as for example in the hospice at home and the management of gief of families left behind. In order also to seek for better terminal care, an emphasis has placed upon the necessity of bio-ethical evaluation of death and of education to prepare for death. There are also some hot topics in relation to the practice of terminal care such as organ plantation, brain death and the use of artificial organs. Along with further impovement in medical science and technology toward the 21st Century, new and difficult proplems will occur in the field of terminal care. It is impossible, however, to stop death no matter how much improvement medical science and technology may make. Today terminal care needs to establish itself under a new paradigm which is different from that of the old theory and practice of treatment medicine aiming at cure. The purpose of this new approach is not to fight against death, but to harmonize with death which is the fate of human life. It is therefore necessary to develop holistic medicine by integrating ethics, medical psychology, sociology and other related disciplines.