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On Supporting the Self-determination of Patients in Terminal Care:Thinking from the Philosophical Perspective

Research Project

Project/Area Number 17H06553
Research Category

Grant-in-Aid for Research Activity Start-up

Allocation TypeSingle-year Grants
Research Field Philosophy/Ethics
Research InstitutionUtsunomiya University

Principal Investigator

YAMADA YUKIKO  宇都宮大学, 教育学部, 准教授 (90344910)

Research Collaborator Murakami Eri  
Chishima iwao  
Project Period (FY) 2017-08-25 – 2019-03-31
Project Status Completed (Fiscal Year 2018)
Budget Amount *help
¥260,000 (Direct Cost: ¥200,000、Indirect Cost: ¥60,000)
Fiscal Year 2018: ¥130,000 (Direct Cost: ¥100,000、Indirect Cost: ¥30,000)
Fiscal Year 2017: ¥130,000 (Direct Cost: ¥100,000、Indirect Cost: ¥30,000)
Keywords哲学 / 倫理学 / 生命倫理 / 終末期 / ケア / 自己決定 / 死生学 / 生命 / 倫理 / 医療 / 医療者支援
Outline of Final Research Achievements

This is a philosophical study in order to be able to support "the self-determination of terminal patients". In this study we have ① prospected for making "self-determination support manual" by Tochigi Medical Center, and also had "the monthly sessions studying medical ethics" with the palliative care team. ②Through these chances of the exchange of opinions and by the way of questionnaire surveys, it has become clear that for the medical team not only 1)relationship with patients, 2)relationship with their families and 3) inner relationship in the medical team, but also 4) the problems in their working environments are more serious than expected. ③ “Self-determination” (or traditionally, living will) in bioethics is empty in the actual field of terminal care and instead of them the necessity for ACP, and for a support from outside of the medical field (“Social Prescription” in the community)became clear.

Academic Significance and Societal Importance of the Research Achievements

1)医療スタッフとの「生命倫理勉強会」を通じ、生命倫理学の理論的蓄積と医療現場との「ギャップ問題」を解決するため、理論と実践のフィードバック的研究を目指した。2)終末期医療では、個人の「自己決定権」にかえてACPの取組み、地域での「社会的処方」のの必要性が明らかとなった。3)ACP普及のために、連携医師らと共に、いわば潜在的患者としての若年層(小5~高校)を対象とした「死生学教育」の試み(18年8月「とちぎこども未来創造大学」)を実施した。4)患者の「全人的ケア」のためにも、現場で疲弊する<医療ケア者のためのケア>こそがむしろ急務であることが明らかとなった。

Report

(3 results)
  • 2018 Annual Research Report   Final Research Report ( PDF )
  • 2017 Annual Research Report
  • Research Products

    (3 results)

All 2019 2018

All Journal Article (1 results) (of which Open Access: 1 results) Presentation (2 results) (of which Int'l Joint Research: 1 results,  Invited: 1 results)

  • [Journal Article] ドイツ観念論およびヘーゲル哲学における「生命」概念-「生命とは何か」という問いそれ自体を問いながら2019

    • Author(s)
      山田 有希子
    • Journal Title

      哲学

      Volume: 70 Pages: 106-122

    • NAID

      130007634064

    • Related Report
      2018 Annual Research Report
    • Open Access
  • [Presentation] ドイツ観念論およびヘーゲル哲学における「生命」概念-「生命とは何か」という問いそれ自体を問いながら2018

    • Author(s)
      山田 有希子
    • Organizer
      日本哲学会 第77回大会 学協会シンポジウム「生命とは何か」
    • Related Report
      2018 Annual Research Report
    • Invited
  • [Presentation] Death education for children:based on oncology and ethics.2018

    • Author(s)
      Eri Murakami,Yukiko Yamada, Iwao Chishima, Nobuyuki Takahashi, Masaru Wakatsuki(*Poster Session, Presenter Eri Murakami)
    • Organizer
      Federation of Asian Organization for Radiation Oncology 2019, in Indonesia
    • Related Report
      2018 Annual Research Report
    • Int'l Joint Research

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Published: 2017-08-25   Modified: 2020-03-30  

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