The new
york times
‘If This Were Your Mother, Doctor…’
By HAIDER JAVED WARRAICH, M.D.
'If This Were Your Mother, Doctor...'
http://nyti.ms/15h6M9p
文章中提到了一位年齡已高的婦人，插管，昏迷送進ICU。這時，家屬該怎麼做？積極搶救？或是，安寧療法？身為一個旁觀的醫療人員，似乎做決定容易些，但是身為一位家屬，這決定是會很困難的。作者這一段寫的很好「We kept our elbows off the table, maintained eye contact (but
not too much) and gave the family an update of where we stood.」, 原來這時候，應該要這樣的身體語言(body language)。
ICU的家屬家庭會議期望中是這樣的，「A healthy family meeting, we’d been told, involved us speaking for about
half the time, with the family speaking for the rest – venting, questioning,
grieving and hoping, in no particular order.」醫療人員不要一直說話，要讓家屬有一半的時間發揮。
重點來了，家屬「asked the one question I had dreaded being asked the most: “Doc, give it
to me straight. If this were your mother, what would you do?”」這問題真是很難回答。
So I have come to believe that the right answer
to the question, “If this were your mother, doctor…” is: “Tell me more about
your mother.” 是的，解鈴還須繫鈴人。家屬應該要去想，他們的母親是怎樣的一個人，她對生命的看法是如何？這時家屬開始回想他們的母親是一位獨立的女性，甚至不喜歡別人幫她開門，她喜歡陽光戶外生活，而且，她絕對不會去住安養院。
醫生作者接下來說明患者的vital sign, lab data和臨床的判斷，並說明將來患者回復到原來的生活型態機會渺茫。這時家屬交換了眼神，彼此的肩膀都放鬆了，眼中的淚水也不再那麼多了，大家似乎沈浸在對這媽媽的回憶之中。經過沈寂半刻，家屬轉身面對醫人員，要求醫療人員讓他們的母親好過一些(comfortable)，並關掉呼吸器。
這文章真是寫到我的心坎裡啊
台灣基層透析協會, 透析週報
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