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首页> 美国卫生研究院文献>Journal of Palliative Medicine >Seeking and Accepting: U.S. Clergy Theological and Moral Perspectives Informing Decision Making at the End of Life
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Seeking and Accepting: U.S. Clergy Theological and Moral Perspectives Informing Decision Making at the End of Life

机译：寻求和接受：美国神职人员的神学和道德观点为生命终结时的决策提供了信息

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>Background: People with serious illness frequently rely on religion/spirituality to cope with their diagnosis, with potentially positive and negative consequences. Clergy are uniquely positioned to help patients consider medical decisions at or near the end of life within a religious/spiritual framework.>Objective: We aimed to examine clergy knowledge of end-of-life (EOL) care and beliefs about the role of faith in EOL decision making for patients with serious illness.>Design: Key informant interviews, focus groups, and survey.>Setting/Subjects: A purposive sample of 35 active clergy in five U.S. states as part of the National Clergy End-of-Life Project.>Measurement: We assessed participant knowledge of and desire for further education about EOL care. We transcribed interviews and focus groups for the purpose of qualitative analysis.>Results: Clergy had poor knowledge of EOL care; 75% desired more EOL training. Qualitative analysis revealed a theological framework for decision making in serious illness that balances seeking life and accepting death. Clergy viewed comfort-focused treatments as consistent with their faith traditions' views of a good death. They employed a moral framework to determine the appropriateness of EOL decisions, which weighs the impact of multiple factors and upholds the importance of God-given free will. They viewed EOL care choices to be the primary prerogative of patients and families. Clergy described ambivalence about and a passive approach to counseling congregants about decision making despite having defined beliefs regarding EOL care.>Conclusions: Poor knowledge of EOL care may lead clergy to passively enable congregants with serious illness to pursue potentially nonbeneficial treatments that are associated with increased suffering.
机译：>背景：患有严重疾病的人经常依靠宗教/精神状态来进行诊断，可能会带来积极和消极的后果。神职人员处于独特的位置，可以帮助患者在宗教/精神框架内或接近生命终点时考虑医疗决策。>目的：我们的目标是检查神职人员对生命终结（EOL）护理和关于信念在重症患者EOL决策中的作用的信念。>设计：关键知情人访谈，焦点小组和调查。>设置/主题：作为国家神职人员报废项目的一部分，美国五个州的35名活跃神职人员。>评估：我们评估了参与者对EOL护理的知识和进一步教育的愿望。为了进行定性分析，我们记录了访谈和焦点小组的情况。>结果：神职人员对EOL护理的知识很差； 75％的人希望进行更多的EOL培训。定性分析揭示了严重疾病决策的神学框架，在寻求生命和接受死亡之间取得平衡。牧师认为以舒适为重点的治疗与他们的信仰传统对善后的看法一致。他们采用了道德框架来确定EOL决定的适当性，该决定权衡了多种因素的影响并坚持了上帝赋予自由意志的重要性。他们认为EOL护理选择是患者和家庭的主要特权。尽管有关于EOL护理的明确信念，神职人员描述了对决策者的矛盾态度和消极方法，以咨询他们的意见。>结论：对EOL护理知识的匮乏可能导致神职人员被动地使患有严重疾病的con病者能够寻求潜在的无助与痛苦增加相关的治疗。

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