临终关怀社会工作的本土实践与伦理困境——以癌症末期患者个案服务为例  

Localized Practice and Ethical Dilemma of Social Work in Hospice Care:Taking the Casework of Terminal Cancer Patient as an Example

作　　者：刘焱 丰芮 LIU Yan;FENG Rui(School of Social Work,China Women's University,Beijing 100101,China)

机构地区：[1]中华女子学院社会工作学院,北京100101

出　　处：《中国医学伦理学》2023年第8期866-872,共7页Chinese Medical Ethics

基　　金：中华女子学院校级课题“疫情时期网络媒介中的医护人员性别形象研究”(KY2020-0304)。

摘　　要：临终关怀社会工作在回应癌症末期患者及其家属需求方面的积极作用受到重视,同时也引发有关本土伦理问题的讨论。以癌症末期患者个案服务为例,分析临终关怀社工实践中伦理困境的具体表现及其成因,进而为伦理问题的应对提供思路。研究发现,临终关怀个案服务工作者面临四重伦理困境,分别为生活质量困境、情感边界困境、权力关系困境以及文化尊重困境。服务管理者可以完善医社协同服务机制,构建全过程专业督导体系,开展关系类社工技能培训,拓展患者与家属生命教育服务,以提升一线工作者的伦理议题应对能力。临终关怀社工服务中的伦理困境具有一定本土性,并会对服务效果带来影响,该议题的回应需要政府、社会、高校、医院以及一线社工等多方主体的共同参与。The positive role of hospice social work in responding to the needs of terminal cancer patients and their families has been highlighted,and has also triggered discussions on localized ethical issues.Taking the casework of terminal cancer patients as an example,this paper analyzed the specific manifestations and causes of ethical dilemmas in the practice of hospice social work,and then provided ideas for coping with them.It was found that hospice care casework workers face four ethical dilemmas,including quality of life dilemmas,emotional boundaries dilemmas,power relationship dilemmas,and cultural respect dilemmas.Service managers can enhance the ethical issue response ability of front-line workers by improving the collaborative service mechanism between medical and social institutions,constructing a wholeprocess professional supervision system,conducting skills training for caring social workers,and expanding patient and family life education services.The ethical dilemmas in hospice social work service are localized,and will affect the service effect.The response to these issues requires the joint participation of the government,society,universities,hospitals,and front-line social workers.

关 键 词：临终关怀社会工作 本土实践 个案服务 伦理困境 

分 类 号：R-052[医药卫生]