Title: ?????? ????? PALLIATIVE CARE
1?????? ????? PALLIATIVE CARE
Inpact 2005
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2
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- 10.15 (5 ????) ???? ????? ????
- 10.25 (40 ???? ) ??? ???? ?? DNR (WIT)
- ?????? ????? ???????
?? ??? ???? ???? ?????? - 11.05(30 ????) "???? ?????? ????" ?????
??????? - ????? ??? ????? -
- 11.30 ( 15 ????) ?????
- 11.45 ( 40 ????) ????, ?????, ?????, ????? -
????? ????????- ????? - BILL OF LAST RIGHTS
- ( 20 ????) - ?????? ?????? ??????
????? - ????? 3 ?????? - 12.45 (45 ????) 13.30 ????? ??????
3
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5?????? ????? ?????? ????
- ??????? ?????? ???????? ?? ????? ????? ?????,
???? ????? ????? ??? ????????? ?????????? ????
???? ????? ??????? ??? ?????? - (Scanlon Flaming, 1989).
6
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?????, ???? ???? ?????, ???? ????? ????? ???
????????? ?????, ???? ?"????? ?????", ?? ?????
????????? ??? ?? ???? ???? ????? ???? ?????????
?????? (Hinds, 2004 Calvin,
2004).
7
7?????? ????? ?????? ????
- ???? ?????? ???? ???? ????? ??????? ?????? ??
????? ????? ?"? ??????? ?? ??????? ?????????
??????, ??? ????? ???????? ?????????. - ?????? ???? ??????? ????? ????? ?? ???? ?? ????
???? ????????? ????????? ???????? ????? ??
????????? ????? - ((Twycross, 1991 Maloney Preston, 1992
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???? ????????, ?????? ?? ????
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(?????????, ????? ????') - ???? ????? - ???? ?? ??????.
- ????? ???? ?? ??????
- ???? ????? ??? ???? ??????/??????
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????.
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?????
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- ?? ?? ????? ???? ??? ????? ?????
- )?????? ?????? ?????? ?????? ???????,
??????? ??????. ( - ?? ????? ??? ?? ???????
- ????? ???????, ????? ????????.
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???????? ?? ????? ??????? ?????. (???? ??, ???
????). - ???? ????????? ??? ?? ????? ????????
- ????? ????? - ?????? "??? ??????, ????
??????".
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19 ?????
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20
20????? ??????? "????? ????? ?? ??????? ????? ??
????????, ?????? ???????, ???? ????? ?????? ??
?????? ?????? ??????". (??? ??? 2002)
21
214 ??????? ?????? ???????
22
224 ??????? ?????? ???????
- ?????? ?????
- Beneficence
- ?? ?? ????? ?????????, ???? ????? ????? ?? ????
??????? ??????. - ????? ????? ?????? ??? ??????? ??????.
23
234 ??????? ?????? ???????
- ????? ?? ????? ???
- Non-maleficence
- ?? ?? ????? ?????????
- ???? ?? ????? ?????
- ??????.
24
244 ??????? ?????? ???????
- Justice?????? ???? -
- ?? ????? ???? ?????? ??, ???? ?????? ???????
??????? ???? ????, ????, ?? ????. - ????? ??????? ????? ????? ?????? ?????.
- ??? ????? ?????? ???? ????, ?? ????? ????? ??
???? ??????? ????? ??? ????? - FUTILE
25
254 ??????? ?????? ???????
- ?????? ??????????
- Autonomy
- ???? ????? ???? ?? ???? ?????? ?????? ?????,
???????? ??????? ???????? ??????, ?? ????
????????, ?????? ??????, ?? ???? ???? ?????
????????? ??????? ?? ?????.
26
26????? ?????? ???????
- ????? ?????? ???? ?? ??? ??? ?????? ?????? ??????
- ?? ??? ?????.
- ??? ???? ????? ??? ????? ????? ?? ????? ????.
- ??????, ???????? ??? ????? ?????.
- ???? ?? ???? ????? ?????? ???? ?????.
- ?????? ????? ????? ?????? ???????( AIDS )
- ????? ??????.
27
27????? ??????? ?????? ?????? ?? ????
???????.........
- Over treatment----------------Neglect
- ?? ?? ????? ????? ?????? ????? ?? ?? ??????
?????? ?????, ??? ????? ???? ????? ?????? ??????
?? ?????. - ????? ?????? ?????? ?? ??? ????? ?????? ???????
??? ??? ????, ???? ?????? ???????? ?? ???? ??????
?????? ???? ?????? ???
28
28?? ??.....
- In health care settings,
- where judgments are made,
- which affect other people,
- a subjective form of ethics,
- or following ones conscience,
- based on personally held values and beliefs,
- is inadequate and would be a weak argument
- in a court of law.
29
29????? ???????? ???????????? ???? ?? ???????
?????? ?????? ?????
- ??????? ????????
- ???????? ?????
- ?????
- ????? ???????? ???? ???? ?? ??????
- ???????? ?????? ?? ??????? ????????
30
30???????? ???????? ????? ?? ?????? ?????
- Teleology (Consequentialism)
- Deontology (Non Consequentialism)
31
31Consequentialism
- ????? ????? ????? ??????? ????? ??? ?? ??
?????? ????. - ??????? ????? ????? ?? ?? ??????.
- ???? ????? ???? ?? ?? ???? ??, ?? ??? ???? ??
?????? ????? - ????? ?????? ????? ?? ???? ?? ??? ???? ????
- ??? ?? ??? ??
- ?????? ????? ????? ??????? ???????? ?????.
32
32Deontology( Non Consequentialism)
- ????? ?? ?? ?? ??????, ?????? ???? ????? ??????
?? ?????. - ?????? ??? ?????? ?? ??????? ??????.
- ????? ?????? ??? ????? ?????.
- ?????? ???????? ????? ???? ????? ?? ???? ????
?????? ?? ??????? ???????.
33
33?????
- ??? ?????? ?????
- ???? ???? ??????
- ???? ???? ??????
- ???? ???
- ????? ????? ???? 2002
- ????? ???????? ??????? ????? ????? ???? (????'
????? ????????) - 2. "??? ?????? ??????? ???????
- ADVANCED MEDICAL DIRECTIVES
- 3. ????? ??-???
- Bill of Last Rights
-
34
34?????? ?????? ?????? ?????
- Fleetwood J. (1989) Solving bioethical dilemma -
a practical approach, Nursing. 89 pp.63-64 - Fletcher J.C., Hite, C.A., Lombardo, P.A.,
Marshall, M.F. (1997). Introduction to Clinical
Ethics, 2nd Edition. Frederick, MO University
Publishing Group. - ?????, ?. (1991) "???? ????? ???? ????? ???? ??
???? ?????? ????? ??????" ???? ?????? ?????
???????? ?????? ??????? ????? (2004) ?????? ???
????, ?????? ????? ??????? ????, ????? ?????
???????.
35