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With the advent of an aging society and the improvement of social civilization, people's all-round quality of life system engineering requires not only eugenics, excellent education, excellent living, but also good death. Paying attention to death, respecting death, choosing death, and helping people to "escape" will become an inevitable trend in the development of modern society. This article will review the concept of evanescent, related theories, assessment tools, research status at home and abroad and influencing factors, and provide suggestions for the elderly to achieve "good death".
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With the development of medical technology, terminal stage patients rely excessively on medical equipment to prolong their lives, but this aggravates the pain of dying patients. The current situation drives the Taiwanese people to think deeply about the following issues: Does the quality of life before death outweigh the ineffective medical treatment at the end of life? Is the patient's autonomy higher than the right to life? This article started with several cases that triggered the discussion of euthanasia in Taiwan, such as the case of Mr. Fu Daren, a sports anchor in Taiwan, who wished to pass legislation on euthanasia. Meanwhile, this paper reviewed the revision process of the "hospice palliative care rules" in Taiwan, and introduced the spirit of "patient autonomy rules" to be implemented in 2019. From the perspective of the revision of the regulations, the current trend was further explored. The awareness of Taiwanese people on the right of self-determination in their final life was improved, and the pursuit of the quality of their final life was more than the extension of their lives.
ABSTRACT
With the advent of an aging society and the improvement of social civilization, people's all-round quality of life system engineering requires not only eugenics, excellent education, excellent living, but also good death. Paying attention to death, respecting death, choosing death, and helping people to "escape" will become an inevitable trend in the development of modern society. This article will review the concept of evanescent, related theories, assessment tools, research status at home and abroad and influencing factors, and provide suggestions for the elderly to achieve "good death".
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Objective@#To evaluate the reliability and validity of Chinese-version Good Death Inventory among oncology nurse specialists.@*Methods@#A further revision has been made in the Chinese-version Good Death Inventory from Taiwan experts through expert review and preliminary experiment. The reliability and validity of the Chinese-version GDI was evaluated among 180 oncology nurse specialists.@*Results@#The Chinese-version of GDI was easy to understand. Most respondents finished the whole scale in 25 minutes and the valid response rate of the scale was100%. The I-CVI value of each item was 0.67-1.00, S-CVI/Ave was 0.938. KMO was 0.832, and the revised Chinese-version GDI consisted of 54 items in 18 dimensions (Core 10 Domains and Optional 8 Domains). The total scale′ s Cronbach′ s alpha coefficient was 0.950, split-half reliability coefficient was 0.832. Cronbach′ s alpha of Core 10 Domains was 0.938 and that of Optional 8 Domains was 0.876.@*Conclusions@#The Chinese-version GDI is a valid scale to measure end-of-life care comprehensive outcomes from Chinese oncology nurse specialists′ perspective.
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<p>Good Death Scale (GDS) is a provider assessment scale of quality of dying of terminally ill cancer patients, and its reliability and validity has been confirmed. The aim of this study is translating the GDS into Japanese (GDS-J) according to the standard methods of conducting linguistic validation. In the forward translation, there was a disagreement in the translation of “will” into Japanese translation of “will” of GDS question 3 “Has the patient arranged everything according to his/her own will?” We confirmed linguistic validity in the research team and eventually got approval from the original author in writing and decided on GDS-J. Using the GDS-J, a quality assessment scale for palliative care by provider, it will be possible to evaluate the quality of palliative care to be done by themselves and to be expected to be useful for providing higher-quality palliative care.</p>
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Resumen: El sentido de la vida, la razón profunda del anhelo de vivir y la motivación para actuar en consecuencia, es el antecedente del proyecto vital (PV). Se argumenta cómo la lucha por la dignidad es el verdadero derrotero de superación de la condición humana y el eje de PV que aspiran al bien vivir. El PV que se propone es una aventura cognitiva que trasciende el consumismo, el individualismo y la pasividad en la búsqueda de otro mundo hospitalario e incluyente, donde tenga viabilidad la superación espiritual, intelectual y moral de la dignidad humana. Este PV entraña: a) una necesidad primaria: vincularse con otras subjetividades afines; b) un núcleo: la lucha incesante por la dignidad sublimada; c) un desiderátum: el bien vivir de las mayorías y d) un propósito indeclinable: la edificación sobre otros basamentos éticos, políticos, jurídicos, cognitivos y ecológicos, de un mundo propicio para el bien vivir. Se arguye acerca de la superioridad de proyectos vitales altruistas en la consecución del bien vivir comunitario, sobre los afanes centrados en la preservación y el cuidado de la salud que favorecen el individualismo, la pasividad y el statu quo. La búsqueda del "bien morir" es el mejor ejemplo de la influencia benéfica de este tipo de proyectos en el cuidado de la salud.
Abstract: On the basis that life project as the driving force behind the life experience, the quest for human dignity is the way for true progress and the improvement of human condition. It's pointed out the need to be aware of the meaning of life understanding the motives behind our will to live that is the antecedent of life project. The proposed life project is a cognitive adventure, capable of transcending consumerism, individualism and passivity, toward the creation of a more inclusive world where the improvement spiritual, intellectual and moral can be viable. Said life project entails: a) A primary need: to link oneself with like-minded people that synergize against the prevailing order b) A core: The everlasting struggle for sublimated dignity c) A desideratum: The well-being of the majority d) An unavoidable purpose: The creation of a suitable world build on different ethical, political, lawful, cognitive and ecological foundations. In conclusion, this paper analyzes the influence of projects with an alternate proposal to the endeavors centered in healthcare that favor individualism, passivity and the current status quo. The best example of said alternate proposals is the commonly called "good death".
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BACKGROUND: In recent years, various studies have analyzed the concepts of “good death” and “quality of dying and death” in the world. The objective of this study was to compare community residents and physicians regarding their perceptions of “good death” in a terminal cancer setting in Fukushima, Japan.<BR>METHODS: One thousand residents of Fukushima City (40 years or older) were randomly selected for comparison to the 483 physicians working in the same city. A self-administered questionnaire was used to query residents and physicians on 52 items about “good death.”<BR>RESULTS: The response rate was 73.6% for the residents and 53.0% for the physicians. The concept of “good death” was composed of 14 factors for both groups. We elucidated the structure of the concept of “good death” in the general population and physicians in Japan, and only the third factor, “religion and spiritual beliefs, ” was the same between the general population and physician.<BR>CONCLUSION: The data offers useful information pertaining to palliative care education for medical providers. Specifically, physicians should understand the differences between concepts held by the general population and physicians. For example, some same items were included in factor X (continuance of one's lifestyle) for citizen and factor II for physician. But contribution ratios of factor X for citizen and factor II for physician were different. This should lead to the better palliative care provision.
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BACKGROUND: Family doctors are usually point of contact when the elderly think their death is imminent. To properly treat their disease and to provide good care of them and their families, family doctors must know the elderly's perception of a good death and dying. The purpose of this study was to investigate the components of a good death from the elderly. METHODS: We composed 9 questions focusing on good death and dying. A family medicine resident interviewed 35 people ages sixty five or over in Cheonan Welfare Center. The contents were recorded into audiotapes, and then translated and analyzed by quantitative method and coding technique. RESULTS: Among the total 35 respondents, many elders answered that they had thought about death and that the meaning of a death was the end of life, or transition from one world to another in religious belief. In their dying, they hoped that they would be with their offspring or spouse and that they would be in their home or hospital. Old people identified 8 major components of a good death: proper age, death without disease, death before death of their offspring and spouse, dying when whole family get together, death after seeing their family happy, death during sleep, and death without pain. They pointed out that the most meaningful event in their lives were related to their family, occupation and society. CONCLUSION: The elderly identified a good death in view of family as well as personal conditions such as proper age, a death without pain or disease. And most elderly pointed out that meaningful events in their lives were related to their family, occupation and society.
Subject(s)
Aged , Humans , Clinical Coding , Surveys and Questionnaires , Euthanasia , Hope , Occupations , Religion , Spouses , Tape RecordingABSTRACT
The concept of ′good death′ is one of the core concepts of hospice.To help medical students build up this concept benefits the development of hospice in China.Therefore,it should be introduced in many aspects in medical ethics teaching.