PDF(Pubmed)
Abstract：
BACKGROUND: Several studies deal with the question of what constitutes a \"satisfactory death\". A smaller number of studies deal with unsatisfactory dying processes. And only a few shed light on unsatisfactory deaths that take place in hospices and palliative care units, which see themselves as places conducive to a \"good\" death. What also remains largely undiscussed are the ethical aspects that accompany the observation of an unsatisfactory course of death.
METHODS: The research was carried out as an exploratory and qualitative study. The data collection and analysis were based on the methods of the \"grounded theory\".
RESULTS: Notions of a bad death are articulated here, though hardly by the affected persons and their relatives themselves, but rather by the professionals. Principally, descriptions of unsatisfactory dying processes refer to deficient success in symptom control, whereby the principle of autonomy is of particular importance. The focus here is not only on the needs of patients, but also on the needs of staff. The manifestation of such notions is related to the requirements arising from a practice that apparently evokes a need for accountability in the form of communicative reassurance.
CONCLUSIONS: An idealised definition of \"dying well\" is in danger of losing sight of the contextual specifics of the practice involved, which can lead to ethically problematic situations.
METHODS: The research was carried out as an exploratory and qualitative study. The data collection and analysis were based on the methods of the \"grounded theory\".
RESULTS: Notions of a bad death are articulated here, though hardly by the affected persons and their relatives themselves, but rather by the professionals. Principally, descriptions of unsatisfactory dying processes refer to deficient success in symptom control, whereby the principle of autonomy is of particular importance. The focus here is not only on the needs of patients, but also on the needs of staff. The manifestation of such notions is related to the requirements arising from a practice that apparently evokes a need for accountability in the form of communicative reassurance.
CONCLUSIONS: An idealised definition of \"dying well\" is in danger of losing sight of the contextual specifics of the practice involved, which can lead to ethically problematic situations.
摘要：
背景：一些研究涉及什么构成“令人满意的死亡”的问题。较少数量的研究涉及不令人满意的死亡过程。只有少数人揭示了临终关怀和姑息治疗单位中不令人满意的死亡，他们认为自己是有利于“好”死亡的地方。在很大程度上还没有讨论的是伴随着对不满意的死亡过程的观察的伦理方面。
方法：本研究是一项探索性和定性研究。数据收集和分析基于“扎根理论”的方法。
结果：这里阐述了严重死亡的概念，虽然几乎没有受影响的人和他们的亲属自己，而是由专业人士。原则上,对不满意的死亡过程的描述是指症状控制缺乏成功，因此，自治原则尤为重要。这里的重点不仅是病人的需求，还需要员工。这种概念的体现与一种做法所产生的要求有关，这种做法显然唤起了以交流保证的形式对问责制的需要。
结论：理想化的“死好”定义有可能忽略所涉及实践的背景细节，这可能会导致道德问题。
方法：本研究是一项探索性和定性研究。数据收集和分析基于“扎根理论”的方法。
结果：这里阐述了严重死亡的概念，虽然几乎没有受影响的人和他们的亲属自己，而是由专业人士。原则上,对不满意的死亡过程的描述是指症状控制缺乏成功，因此，自治原则尤为重要。这里的重点不仅是病人的需求，还需要员工。这种概念的体现与一种做法所产生的要求有关，这种做法显然唤起了以交流保证的形式对问责制的需要。
结论：理想化的“死好”定义有可能忽略所涉及实践的背景细节，这可能会导致道德问题。
