家族が捉えた死の迎え方の倫理的意思決定の過程とその要因の探索  [in Japanese] A retrospective study on ethical decision-making in end-of-life from family perspective  [in Japanese]

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Abstract

本研究は、終末期患者の死の迎え方の倫理的意思決定過程とそれに影響した要因の探索を目的に、家族の一員を最近亡くした12家族に面接調査を行い、それを質的に分析した。その結果、死の迎え方の意思決定に影響した要因として、(1)患者と家族が得た情報、(2)患者の意思表明、(3)患者の人となり、(4)家族と患者の精神的距離、(5)家族の価値観、および(6)家族の倫理的義務感が現れた。これらの要因によって、死の迎え方の意思決定過程は、【患者自身が決める】、【家族と医師の話し合いで決める】、【医師が決める】、および【決定の先送り・決めない】の4パターンをとることが明らかになった。家族が、「(患者は)よい死だった」と語ったのは、【患者自身が決める】と【家族と医師の話し合いで決める】過程をとった場合のみであった。

This study is about decision-making at the end-of-life. The aim of the study is to show (1) the dynamics of decision-making after the patient was diagnosed with terminally illness, (2) the process these family members used to make the decisions, and (3) the factors that influenced this process. The methodology was 12 in-depth interviews. Findings included four patterns of ethical decision-making and six influence factors. The patterns were (1) patient decided, (2) family and physician discussed and decided, (3) physician decided, and (4) no direct decision because patient's death not seen as immediate. The factors that influenced these decision-making dynamics were patient and family provided information, patient told wishes clearly to family and physician, patients' personality, family values, family obligations, and family psychological distance from patient. In only two of these patterns did family members talk of the patient experiencing a good death.

Journal

  • Bioethics

    Bioethics 12(1), 84-91, 2002

    Japan Association for Bioethics

References:  22

Cited by:  2

Codes

  • NII Article ID (NAID)
    110004833318
  • NII NACSIS-CAT ID (NCID)
    AN10355291
  • Text Lang
    JPN
  • Article Type
    Journal Article
  • ISSN
    1343-4063
  • Data Source
    CJP  CJPref  NII-ELS  J-STAGE 
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