我國安寧緩和照護之相關政策的過去發展與未來展望

Hospice Palliative Care Policy in Taiwan: Past Developments and Future Perspectives

醫護人員要「救生」，也要「顧死」，照顧病人，應該是「從子宮到墳墓」，從出生到死亡，而最後階段的臨終關懷，更應發揮「拔苦予樂」的宗教情操與人文精神。1990年馬偕醫院在淡水分院設立「安寧病房」，是我國安寧療護實務的開始。健保的給付、〈安寧緩和醫療條例〉的立法、醫院評鑑的重視與臨床宗教師制度的建立，使安寧工作能夠順利開展。未來希望加護病房推行台灣昏迷指數，可以縮短臨終病人的痛苦與減少醫療資源的浪費。期許將來能夠全面推廣社區安寧照護，讓大部分的病人能夠壽終正寢，在家中安詳往生。

The duty of medical personnel is to save lives, cure diseases, relieve suffering, and promote health. Medical personnel care for their patients from birth to death. At the end of terminal care, medical personnel should maintain a religious / holistic commitment to their patients to ＂remove their suffering and provide happiness＂ as much as possible. Mackay Hospital opened the first hospice in Taiwan in 1990. Financial coverage of hospice care by the National Health Insurance, the enactment of the Hospice Palliative Act, the attention of Hospital Accreditation to hospice care, and the establishment of the system of clinical chaplaincy have all contributed to the development of hospice palliative care in Taiwan. Application of the Taiwan Coma Scale has been shown to decrease the use of futile life sustaining treatments in the ICU. The author hopes that nurses may further expand community hospice care services to help facilitate the peaceful dying of terminal patients at home.