Madokotala ndi Imfa: Kodi Udokotala ndi Udindo ndi Udindo ndi chiyani kwa odwala?
Madokotala akamasankha kukhala madotolo, ambiri amangofuna kuthandizira kupewa matenda ndi imfa, kuwathandiza kukhala ndi thanzi labwino komanso chithandizo cha odwala awo, komanso kuchiza, kuchiza, ndi kuchiza odwala nthawi iliyonse yomwe mankhwala angathe.
Koma, bwanji ngati ngati dokotala mukupeza kuti palibe china chomwe mungachite kuti muthandize wodwala kukhala bwino? Bwanji ngati palibe chimene mungachite kuti muthandize wodwalayo kukhala ndi moyo wapamwamba?
Bwanji ngati wodwala akuvutika kwambiri, kuti akufunadi kufa , osati kukhala ndi ululu, osasangalala ndi moyo? Bwanji ngati mbali ya ntchito yanu ikuphatikizapo kulola wodwalayo kuti afe, kapena kumuthandiza wodwalayo kuti achite zimenezo? Monga dokotala wophunzitsidwa kuchiza ndi kupitiriza moyo, kodi mumagwirizanitsa bwanji zokhumba za wodwalayo wodwalayo, ndi ntchito yanu ngati dokotala kupulumutsa miyoyo ndi 'kusavulaza'?
Monga kupita patsogolo kwachipatala kumathandiza odwala kuti akhale ndi moyo nthawi yaitali moyo wawo utatha, chiwerengero cha madokotala akuchirikiza kayendetsedwe kothandiza odwala kutenga moyo wawo ndi imfa, ndikupita kumapeto kwa moyo ndi ulemu , mosiyana ndi kuwonongeka.
Madokotala a ku America tsopano akuthandiza imfa mwaulemu kudzera mwa thandizo lachipatala pakufa ndi chigawo cha 23 peresenti (54% vs. 31%), malinga ndi kufufuza kwa Medscape anagwa madzulo 17,000 a madokotala a ku America omwe akuimira zochitika zachipatala 28.
Komabe, chiŵerengerochi chikuvumbulutsanso kuti palinso madokotala ambiri omwe sadziwa kuti ayenera kuthandiza wodwalayo kuti afe.
Magaziniyi inabweretsedweratu posachedwa ndi mtsikana wina yemwe atapezeka kuti ali ndi matenda odwala, adagwiritsa ntchito masabata angapo apadziko lapansi kuti aphedwe ndi ufulu wofa ndi ulemu.
Kuti awononge njira yake ya kutha, Brittany Maynard anasamukira ku Oregon, chimodzi mwa mayiko asanu kumene panopa amalembedwa kuti apeze thandizo lachipatala podzifa payekha. Ndi thandizo lachipatala, maynard anamaliza moyo wake asanatuluke matenda ake pang'onopang'ono. Mayi Maynard ndi banja lake adalengeza ulendo wake, akusiya chuma chamtengo wapatali cha imfa ndi ulemu, komanso kuwonjezeka kwakukulu kwa kayendetsedwe kowonjezereka.
Chifundo ndi Kusankha, bungwe lakale kwambiri ndi lalikulu kwambiri la dzikoli lomwe likugwira ntchito kuti lipititse patsogolo chisamaliro ndi kupititsa chisankho chamapeto, linakhazikitsa gulu lachidziwitso la madokotala lotchedwa Doctors for Dignity. Iwo akuyembekeza kufalitsa chidwi pakati pa madokotala kuti athandize kusintha ndondomeko m'mayiko otsala kuti alembe thandizo lachipatala pakufa. (Pakali pano ndilamulo ku Oregon, Washington, Montana, Vermont, ndi New Mexico, pamene mayiko ena 23 ali ndi ngongole zothandizira kuti izi zitheke, malinga ndi Madokotala a Ulemu.)
Kuwonjezera apo, Chisomo ndi Zosankha ndi Madokotala omwe ali ndi Ulemu akuyitanitsa AMA kusintha kayendedwe kake pa thandizo lachipatala kuti athetse zosankha za moyo. (AMA panopa ikutsutsa izo.)
"Ngakhale kuti AMA yatsutsana kwambiri ndi thandizo lachipatala pakufa, ndikuganiza kuti ambiri AMA mamembala - monga ine - kuthandizira izo," adatero Dr. Eric Kress, membala wa AMA komanso dokotala wodziwika bwino pa mankhwala achipatala, chipatala komanso mankhwala opatsirana. Missoula, Montana yemwe akupezeka pa intaneti yojambulira anthu. "Madokotala ambiri amadziŵa kuti mwadzidzidzi ngakhale chisamaliro chabwino kwambiri cholandilira alendo komanso kuchepetsa ululu sizingathetseretu mavuto onse omwe akudwala. Tikukulimbikitsani madokotala omwe amawathandiza thandizo lachipatala pofera kulankhula mwa kuyanjana ndi Madokotala a Ulemu. "
Madokotala akuthandizira thandizo lachipatala pakufa angakhudzidwe ndi kuthandizira kwawo kwakukulu pakati pa odwala awo.
Pafupifupi anthu asanu ndi awiri (10) alionse ku America (68%) amavomereza kuti "anthu omwe ali ndi matenda odwala, omwe amavutika kwambiri komanso osapulumuka, ali ndi ufulu wosankha kuti apulumuke," malinga ndi kafukufuku wa Gallup's Values and Beliefs. Gallup adanena kuti thandizo "lakhala likukula pafupifupi zaka 20 m'zaka ziwiri zapitazo ndipo likuyimilira pazaka zoposa khumi."
Tinaphunzira zambiri pa nkhaniyi kudzera mwa kuyankhulana kwa imelo ndi Mary Steiner, Coordinator, Madokotala Olemekezeka, ndi Matt Whitaker, Mtsogoleri wa Oregon State ndi Mtsogoleri Wachifundo Wopereka Cholinga cha National Healthcare Provider for Compassion & Choices.
Q: Nanga ndi chifukwa chiyani madokotala aulemu anakhazikitsidwa? Bwanji tsopano? Ndani anayambitsa izo, ndipo kudzoza kunali chiyani?
Madokotala Olemekezeka: Chifundo ndi Zosankha zimazindikira kuti madokotala amatha kumvetsera madokotala ena pokhudzana ndi kukhazikitsa ndondomeko. Cholinga chathu ndi kupereka zokhudzana ndi kukonza mapeto a moyo, kuphatikizapo thandizo lakufa.
Pali mphamvu zambiri. Madokotala a Ulemu amapereka "chivundikiro" kwa ena ndikupereka chithandizo ndi maphunziro kwa wina ndi mnzake. Cholinga chimodzi ndi kulola madokotala kukhala owona bwino komanso ogwirizana ndi odwala awo omwe akukumana ndi mavuto otsiriza. Cholinga china ndi kusuntha mabungwe otsutsana ndi kuwathandiza kuti asalowerere kapena kulowerera. Pamene madokotala amalankhula momasuka za malo awo, zimathandiza kukwaniritsa cholinga ichi.
Madokotala adzakhala oyankhula pa misonkhano yachipatala ndikupereka uthenga ndi maphunziro. Madokotala Olemekezeka adzalemba makalata kwa mkonzi ndikupereka umboni wa "akatswiri" ku malamulo ndi khoti ngati kuli kofunikira. Chofunika kwambiri ndi kulola madotolo kukhala ndi malo oti adzalimbikitsire ndi kufunafuna mfundo zowonjezereka za moyo, kuphatikizapo imfa ndi ulemu.
Q: Kodi umembala wakukula umakhala bwanji posachedwapa? Kodi pali madokotala aliwonse omwe angakhale ovomerezeka? (mwachitsanzo, ndi madokotala aang'ono omwe amawatsegulira, kapena pali zinazake zapadera zomwe zikuwoneka / zikugwiritsidwa ntchito, etc.)
Madokotala Olemekezeka: Kukula Madokotala a Ulemu waumwini kumawoneka kuti akugwirizana ndi zochitika zadziko. Tinapeza mamembala pamene Brittany Maynard anali kulengeza poyera thandizo kuti afe. Madokotala a California adabwera m'bwalo lalikulu chifukwa cha malamulo othandizira omwe amaperekedwa mu bwalo lamilandu la boma ndipo tawona anthu ambiri akugwirizana pa msonkhano wa AMA. Timalandiranso mamembala pamisonkhano ina pamene Compassion & Choices ili ndi kupezeka.
Madokotala a mibadwo yonse akuphatikizana ndi kayendetsedwe ka moyo womaliza. Komabe, iwo amene amathera nthawi ndi odwala omwe ali ndi matenda othawa amatha kukhala ndi mgwirizano wambiri pa chifukwa chomwe adzionera okha kufunika kwa chisamaliro cha umoyo, chokhazikika pamapeto.
Q: Kodi munganene chiyani kwa dokotala yemwe ali "pa mpanda" ponena za nkhaniyi - mwinamwake iwo akuvutika kuti agwirizane zomwe amaphunzitsidwa ku sukulu ya zachipatala: machitidwe azachipatala, ndi ufulu wa wodwalayo kufa ndi ulemu. .
Madokotala Olemekezeka: Kukambirana za machitidwe azachipatala ndi chisamaliro cha kutha kwa moyo nthawi zonse kumachitika ndi matekinoloje atsopano, machitidwe a chisamaliro ndi malingaliro a chikhalidwe, koma pakati pa chitukuko chonse ndiko kuzindikira kufunika kwa kugawana kupanga ndi kuyankhulana kwabwino . Zanenedwa kuti odwala ndi aphunzitsi abwino kwambiri. Ndingalimbikitse madokotala kuti azichita nawo odwala awo ndikumvetsetsa ndi zochitika zawo. Ayikeni pakatikati pa ndondomekoyi ndipo maganizo anu adzasintha.
Q: M'madera omwe kuli kovomerezeka kupereka chithandizo pakufa, kodi lamuloli lasokoneza bwanji chisankho chamapeto?
Madokotala Olemekezeka: Chaka chino, chifukwa cha thandizo lachipatala la otsogolera odwala, madokotala ambiri kuposa omwe adathandizapo odwala kupyolera mu imfa ndi kulemekeza malamulo ku Oregon (kuwonjezeka kwa 34% pa 2013).
Q: Kodi dokotala ayenera kuchita chiyani ngati akufuna chidwi? Angathandize bwanji?
Madokotala Olemekezeka: Ndikadandaulira madokotala omwe akufuna chidwi kuti adziwe deta yathu ya Doc2Doc kuti adziwe zambiri zokhudza momwe angathandizire odwala awo ndikulembera madokotala athu a Dignity campaign. Ndimalimbikitsanso kuti mawu awo amveke pokhapokha mwazochita zawo komanso kwa osankhidwa awo.
Q: Kodi vutoli lingayambitse kusagwirizana kulikonse kuntchito ngati madokotala ali ndi malingaliro osiyana? Mwachitsanzo, ngati dokotala wina akufuna imfa ndi ulemu, koma dokotala wina amamva kuti "zathandiza kudzipha" ndipo zimatsutsana kwambiri, kodi zingayambitse vuto lililonse ndi ntchito? Ngati ndi choncho, madokotala ayenera kuchitanji?
Madokotala Olemekezeka: Zomwe takumana nazo ku Oregon zimasonyeza kuti madokotala omwe ali ndi mbiri komanso chiyanjano wina ndi mzake amamvetsetsana maganizo ndi zolimbikitsa. Ena omwe amalimbikitsa kwambiri ntchitoyi amachitira limodzi ndi ena otsutsa kwambiri. Mwa kuyankhulana wina ndi mzake ndi kulemekezana ndi kuchitira chifundo, amatha kugwira ntchito mosamala pamene kusunga zokambirana zokhudzana ndi nkhaniyi zatseguka komanso moona mtima.
Q: Kodi sukulu zachipatala zikukonzekera kapena kusinthira maphunziro awo pokhapokha ngati izi zikuyenda?
Madokotala Olemekezeka: Mu Oregon, sukulu za zamankhwala zonse zimapereka mpata wopita ku maphunziro a zamankhwala othandizira kufa. Ophunzira ambiri a zachipatala m'dziko lonse lapansi akukambirana nafe ndikupeza momwe angaphunzitsire kwambiri za chisankho ichi. Mwezi uno chabe, [ife tinali] osonkhana ndi mabungwe awiri a zachipatala, kum'mwera, momwe angapezere zambiri. Kukambirana kukukulirakulira ndikusintha mofulumira.