週三. 2 月 19th, 2020

屏東基督教醫院 人生的最後一程自己做主

【記者范家豪/屏東報導】 因應病人自主權利法施行,屏東基督教醫院自1月7日開辦預立醫療照護諮商門診,迄今已完成10份預立醫囑,其中就有兩家共八人領風氣之先完成「預立醫療決定書」簽署上傳。屏東縣衛生局局長李昭仁、屏東縣醫師公會理事長鄭英傑、屏基院長余廣亮也都鼓勵民眾趁健康時規劃生命末期的醫療照護,確保自己的尊嚴及善終。

▲屏東縣政府衛生局長與屏東縣醫師公會理事長鄭英傑、屏基院長余廣亮也都鼓勵民眾趁健康時規劃生命末期的醫療照護。(圖/屏東基督教醫院)

生、老、病、死是人生必經的道路,當病況不可能好轉、且神智模糊無法言語時,全身插滿氣管內管、尿管、鼻胃管,仰賴呼吸器維生的醫療照護,是否是自己想要的?為尊重病人醫療自主、保障其善終權益,促進醫病關係和諧所制定的病人自主權利法,讓民眾可以按照自己的意願,提早決定自己在生命末期想要的醫療照護模式。

欲簽署預立醫療決定書,必須年滿20歲民眾在二親等親屬陪同下進行「預立醫療照護諮商」,與醫師、護理師、社工或心理師會談討論,倘若未來面臨生命末期、不可逆轉之昏迷、永久植物人狀態、極重度失智或其他經政府公告之重症等5種特定臨床狀況,自己是否要接受維持生命治療及人工營養及流體餵養,例如心肺復甦術、機械式維生系統、鼻胃管灌食、胃造廔管灌食…等醫療照護。在充分了解並確定心意後簽下「預立醫療決定書」,之後由醫院上傳至衛福部系統並註記於健保卡上,讓醫師及家屬可以依照病人的意願,確保其尊嚴善終之權利。

▲屏東縣政府衛生局長與屏東縣醫師公會理事長鄭英傑、屏基院長余廣亮也都鼓勵民眾趁健康時規劃生命末期的醫療照護。(圖/屏東基督教醫院)

目前專責屏基預立醫療照護諮商門診的蘇慶豐醫師,同時也負責屏基安寧病房、緩和醫療門診,深感當疾病已經不可治癒,延長瀕死過程的無謂醫療徒增病人痛苦,因此當病人自主權利法通過後,便積極地跟家人宣導,蘇醫師跟太太、媽媽、阿姨一家人並以身作則率先簽下「預立醫療決定書」。蘇媽媽姊妹倆幾年前看到自己母親反覆住院,每當醫師問「要不要救?」時,兄弟姊妹沒人敢說不,只好讓母親身上佈滿急救用的醫療管路,又壓又電,最後走時可說是體無完膚,親眼目睹那種辛苦、痛苦,蘇媽媽餘悸猶存,不想自己也經歷一次,所以力邀妹妹一起來簽署。基於避免日後家人陷於「救與不救」的掙扎,免除愧疚與自責的壓力,蘇太太在簽署後告知自己的父母,自己生命末期的醫療選擇和決定。

▲中華小腦萎縮症病友協會秘書長涂衛成(後排中間)與父母哥哥簽下預立醫療照護決定書。(圖/屏東基督教醫院)

中華小腦萎縮症病友協會秘書長涂衛成特別排假回來屏東,偕同爸媽和哥哥一家四口簽下「預立醫療決定書」,涂秘書長表示「也許是原住民對生命的樂觀態度,自小母親就透露未來不想接受插管治療的想法,深覺此種治療模式將會帶給自己及家庭很大壓力。」加上自己曾參與預立醫療相關條文的草擬,更確信應該在「自己有決定能力時,選擇適合自己的醫療照護模式」,預立醫療照護不但顧及個人在生命後期的尊嚴,也能有效的預防醫療資源的浪費,讓照護能多一個選項。

屏基預立醫療照護諮商門診主治醫師蘇慶豐指出,對於永久植物人、極重度失智、不可逆轉之昏迷的病人與家屬來說,長年照護下來,體力、經濟、心靈都備受煎熬。民眾若能在身體健康的時候為自己未來的醫療照護先做準備,那不僅是對自己的疼惜、也是對家人的體貼。預立醫療照護諮商門診為自費門診,需提前兩周預約掛號。

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