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| 題名: | 佛教的生命末期照顧理論與方法：平等、關懷、提升與轉化;A Buddhist Theory and Method of End of Life Care: Equality, Compassion, Enlightenment and Conversion |
| 作者: | 李冠慧;Lee,Kuan- Hui |
| 貢獻者: | 哲學研究所 |
| 關鍵詞: | 佛教;安寧緩和醫療;生命末期照顧;平等;關懷;慈悲;提升;轉化;倫理;Buddhism;palliative medical care;end of life care;equality;caring;compassion;enlightenment;conversion;ethic |
| 日期: | 2016-07-25 |
| 上傳時間: | 2016-10-13 13:48:24 (UTC+8) |
| 出版者: | 國立中央大學 |
| 摘要: | 本研究的主要目的為建構佛教生命末期照顧模式進行的哲學探討，以及為生命末期病患、家屬、工作團隊與種種的生命末期照顧所衍生的倫理問題，找出佛教可依循的根本、一貫的道理和解決的方法。進而從此根本的道理、方法，衍生出的種種權宜善巧的方法用於生命末期照顧之種種面向。論文的進行分為兩大路徑，一為從佛教生命緣起觀、平等觀佛教義理中，認識佛教的教義中認為生命末期病人與照顧者應有的心態，以及在生命末期時提升生命質素的動力。二為嘗試以佛教的視角對常見生命末期照顧的倫理問題如末期病情判定、醫病關係的問題、選擇治療方式、無效醫療、以及醫療資源分配進行探討。
佛教的生命觀以十二因緣來說明無盡的生命循環，有情依過去所造作業，遇緣投胎。有情要從此無盡的輪迴苦中解脫，可藉由解脫道、菩薩道與往生淨土等修行道路來達成。就佛教的平等觀來看，生老病死，皆是緣起性空，平等一貫，生命體無須對死亡特別的排斥與害怕，因為其不過是生命歷程的重要環節，與出生是平等。醫療人員對待病患與家屬，不分貧富貴賤，應為其做平等的考量，給與適當的醫療照顧。醫療資源分配的部分，若依據佛家的利和同均的精神，屬於國家資源的醫療設施與全民健康保險的福利資源對所有的國民也應給予平等運用機會。
理想的佛教的生命末期照顧模式為1.以平等、關懷的心，以及歷程的視角看到病患的過去、現在、未來的苦，苦因，以及滅苦的方法；2.以平等的心來看待病人的每一疾病的階段；3.平等的考量每一位病人的不同階段的需求，依其需求量身打造適切的協助；4.引導的方式要適合病人的程度，並運用其相應的方法。佛教生命末期照顧生命素質提升與轉化的路徑為藉由法門的修持引發智慧力提升，得以脫離死恐懼、生死困頓，提升生命質素。在對家屬沉痛的心情，醫療團隊應給予醫療上全力的支持，並給予適當的陪伴；帶著家屬來看死亡在生命歷程的位置，以及如何幫自己與幫助病人帶出生命的出路。佛教倫理觀於生命末期照顧之無效醫療的部分則是認為應適時將佛教平等觀帶入，坦然的將死亡的過程視為一自然的生命歷程。在生命末期醫療中，常使用的臨終鎮靜，不以縮短生命為方式來減輕末期病患臨終前的痛苦，與佛教慈悲觀的觀念一致，是佛法的倫理可接受的臨終照顧方式。
善終是人人所欲的，若以佛法的觀點若要達此目標，必須平等看待生老病死，並預立醫療指示，預先按照自己的意願安排末期醫療抉擇；並在臨終階段安頓身心於相應的法門，心無罣礙並有所依止的往下一階段的生命邁進
;The main goal of this study is the construction of a Buddhist end of life care model, as well as the solutions of those ethical issues with their families, work teams and all sorts of end of life care according to the fundamental teachings of Buddhism. From the fundamental truth, method of Buddhism, we try to derive a variety of methods to tackle all sort of problems of end of life care. The thesis will be divided into two paths. First, from the Buddhist conceptions of the origin of life and the concept of equality we lay out the basic attitude of the patient and the caregivers, as well as the motivation of enhancing the quality of life of the patient. Second, I try to present the Buddhist perspective on ethical issues common to end of life care, such as the problem of doctor-patient relationship, the choice of treatment, futile medical care, as well as allocation of medical resources.
Buddhist regards life in an endless cycle, sentient creatures are regarded as re-incarnated and re-born according to karma. To be released from this endless cycle of suffering, one has to practice and follow the Way of enlightenment, the Way of Bodhisattva and reborn in the Buddhist Pure Land of Buddha. According to the Buddhist conception of equality for all, to be born-ill-old-death is equal for all. and they are equal among themselves that means we need not fear one or the other, or that death over life for they are but part of a life cycle.
The ideal Buddhist end of life care includes the following. First, patients’ suffering and causes of suffering are treated with equality and compassion and a perspective of life as a process so as to ameliorate patient’s suffering. Second, every stage of patient’s disease should be treated equally and calmly. Third, treatment needs be provided in accordance with patient’s individual and different needs at different stages of disease development. Fourthly, methods of release of pain and promotion of enlightenment have to fit the different degree of patient’s perception and levels of understanding. The Buddhist way of quality of life improvement is a cultivation of enlightenment and conversion from the fear of death and suffering with an expectation of a better life cycle coming. Lastly, this paper also treats in line with Buddhist philosophy a number of end of life issues such as terminal sedation, living will, futile treatment and others. |
| 顯示於類別: | [哲學研究所] 博碩士論文
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