從關懷倫理重建自殺照護

Rebuilding Post-Suicide Interventions from a Caring Ethics Perspective

自殺是台灣目前重要的精神衛生問題。雖然有關自殺的研究幫助了健康專業人員瞭解自殺者死亡前的可能生活情況，卻無法提供自殺企圖者在求助過程中的社會文化脈絡；雖然提醒健康專業人員如何防範、偵測病人的下一次自殺企圖，但是卻遺漏如何陪伴企圖自殺者勇敢得活下去，或活得比以前更好之討論。本文將從關懷倫理的觀點，鼓勵護理人員藉由瞭解病人的解釋模式和反觀自己的照護措施中，和病人進行對話。經由護病關係的轉化，不但減少自殺者在求助過程中的羞恥感，亦激發他們對自己和對他人的責任，同時也幫助護理人員自身建構新的自殺照護知識。

Suicide has become a critical mental health problem in Taiwan. Most studies on the issue are related to suicide rates and risk factors, and their relationships with mental illnesses. These findings help health professionals to understand what life might have been like for a suicide victim before the suicide, but not what life is like after a suicide attempt; how to detect the possibility of a subsequent suicide attempt, rather than how to help people who have attempted suicide to construct a good life. The purpose of this article is to encourage nurses to engage in dialogue with suicidal patients by understanding their explanatory models and by self-reflection. This not only enables suicidal patients to move from shame toward taking responsibility for themselves and others, but also enables nurses to rebuild their experiential knowledge.