| Budget Amount *help |
¥1,350,000 (Direct Cost: ¥1,200,000、Indirect Cost: ¥150,000)
Fiscal Year 2007: ¥650,000 (Direct Cost: ¥500,000、Indirect Cost: ¥150,000)
Fiscal Year 2006: ¥700,000 (Direct Cost: ¥700,000)
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| Research Abstract |
Failure of the problem-solving ability of local communities to catch up with technical innovations at advanced research organizations and high-tech medical facilities is clearly manifested in the confusion concerning surrogate decision-making for dying patients and terminal care. The establishment of a system that provides ethical advice concerning these problems to medical workers at the clinical front line is urgently needed.
In this study, I first addressed terminal care, which is regarded as an issue involving both medical and welfare workers, among ethical problems. I performed a questionnaire survey at all special elderly care homes in Hyogo Prefecture, and clarified that staff members were aware of increasing needs for terminal care and were willing to take on care with highly medical elements. However, the survey also clarified that such activities lack systematic support, that reliable guidelines for actions were deficient, and that feelings of tension and helplessness felt under such circumstances are burdening the staff.
I next attempted to reconstitute ethical problems in relation to legal regulations. When I face difficulty in continuing treatment and care due to an ethical dilemma, I may wish for regulation through laws or rules. However, evils of bureaucracy are unavoidable by such legal paternalism, i.e., direct management by legal rules. I clarified this point by comparing medical care in general including facility and mental care.
I then evaluated an ethical consultation system by out-of-organization members as a problem-solving model to help with various ethical judgments required in the fields of medicine, health care, and welfare. Dilemmas constantly occur in the care of dying patients, and a support system that intervenes for their resolution not dependent on legal rules is indispensable for the prevention of staff exhaustion and burnout.
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