老人安養之道德決策

Ethical Decision for Gerontological Healthcare

由於平均壽命的延長，必然面對身體機能的老化與慢性疾病的呈現，這不僅帶來龐大長期照護的需求，更凸顯老人安養問題的重要性。因此民眾面對此問題，是否選擇自家安養或送至長期照護機構安養，可能在經濟、情感與社會道德（孝道）上產生猶疑或掙扎，造就了面臨孝道困境與道德的兩難。本研究之問卷設計採用三種情境劇本問卷作為衡量工具。研究對象為以1963～1973年開始以後出生的人為主軸，父母親至少一方仍健在之已婚成年子女。本研究共發放450份問卷，有效樣本為312份，有效回收率為89.4%。假設驗證則以複迴歸和階層迴歸分析來檢定，結果發現人口統計變數在道德決策程序的差異，道德強度對道德決策程序的直接效果，以及孝道責任對道德決策程序有調節效果。

As the average life expectancy is lengthened, people will inevitably face the body's aging and chronic diseases, which not only bring substantial long-term nursing needs, but also highlight the importance of gerontological healthcare problems. Thus, the people face the question on whether to send their home or long-term care institute. Economic, emotion and social morality (filial piety) generate hesitation or struggle and create a dilemma between filial piety and ethics. This study uses three kinds of vignette and questionnaire as an assessment tool. The study subjects were people who were born between 1963 and 1973. At least one of their parents is living and they are married. A total of 450 questionnaires were issued with 312 valid responders (response rate of 89.4%). The multiple regression and hierarchical regression analysis were used to analyze the hypotheses. The results show that demographic variables bring difference in ethical decision making process and that moral intensity has a significant direct effect on ethical decision making process. Additionally, the filial obligations have a moderating effect on the ethical decision making process.