【生死教育第三講】
講題 Title:預設醫療指示與預設照顧計劃 Advance Directive and Advance Care Planning
報名鏈接Registration Link: https://bit.ly/3tE9RgE
日期 Date:12/6/2021(Sat)
時間 Time:3:00-4:30pm
地點 Venue:沙田澤祥街12號香港中文大學鄭裕彤樓地下演講廳1A (LT1A)
Lecture Theatre 1A, Level 1, Cheng Yu Tung Building, The Chinese University of Hong Kong, 12 Chak Cheung Street, Shatin, N.T.
講者 Speaker:陳裕麗教授 Prof Helen Chan / 鍾一諾教授 Prof Roger Chung
主持 Moderator:伍桂麟先生 Mr Pasu Ng
講座內容 Synopsis:
現今醫療科技發達,很多疾病均可治癒或受控制。當疾病到了末期,醫療科技有時只能提供維持生命治療,但延長死亡過程對病人可能沒有意義,甚至增加痛楚。面對這情況,病人、家屬和醫護人員可以商討是否中止對生活質素沒有幫助的維持生命治療,讓病人安詳離世。香港中文大學醫學院那打素護理學院副教授陳裕麗博士和香港中文大學公共衛生及基層醫療學院助理教授鍾一諾博士會在由中大公共衞生及基層醫療學院主辦的公眾「生死教育」四講系列的第三講和大家分享『預設醫療指示』 (Advance Directive)和『預設照顧計劃』(Advance Care Planning)的概念與應用。這兩種健康護理選擇不但可以免卻家屬決定病者死時所受到的困難和壓力,減少作出決定後感到矛盾和內疚的機會,亦體現對病者生命和意願的尊重。
Thanks to the advancement of medical technology, most diseases can be cured or subsided. However, there are times that medical technology could only prolong one’s life but could not cure the terminal illness. Facing such situation, patients, family members, and medical staff can discuss whether to withhold or withdraw from life-sustaining treatments that may not help improve patients’ quality of life so that they can die peacefully. Professor Helen Chan, Associate Professor from The Nethersole School of Nursing and Professor Roger Chung, Assistant Professor of the School of Public Health and Primary Care of the Chinese University of Hong Kong, will share with us the concepts and values behind Advance Directive and Advance Care Planning in the third public seminar of the four-lecture series on life and death education organized by the School of Public Health and Primary Care, CUHK. These two health care options aim not only to reduce the pressure faced by patients’ family when making end-of-life healthcare decision, but also show respect to patients’ will.
講者介紹:
Professor Helen Chan’s research interests focus on end-of-life care, gerontology as well as care ethics. She has conducted a number of research projects on promoting palliative and end-of-life care, especially advance care planning, among older adults and people with advanced progressive diseases.
陳裕麗教授的主要研究範疇集中在臨終護理、老年病學和護理倫理學上。她的研究項目包括推廣有關老人和晚期疾病患者的紓緩照顧和臨終護理服務,尤其是預設照顧計劃。
Professor Roger Chung’s research aims to empirically inquire into the social determinants of health inequalities, as well as aging‐related issues on multimorbidity and long‐term/end‐of‐life care, and to utilize such evidence to inform health services and policy, domestically and beyond.
鍾一諾教授的主要研究範疇為健康不平等的社會決定因素,與老年有關的多重疾病,和晚期與臨終護理政策,並運用研究成果為本地及國際公共衛生服務和政策提供意見。
生死教育 X 伍桂麟
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medical ethics中文 在 國家衛生研究院-論壇 Facebook 的最佳解答
➥在應付伊波拉、HIV、結核病、及其他零星傳染病後,非洲幾個國家已具有不錯的疾病反應能力。
非洲政府罕見地提供了COVID-19有效的國際合作。在沒有疫苗及有效的治療藥物之前,普篩是遏止傳染及死亡的重要方法,尤其無症狀感染占了二次感染的44%。雖然每千人僅檢測2.7人,小於德國及南韓,截至2020/4/25止,南非僅4000明確診個案,79人死亡,致死率與其他國家相似。
但每個國家應對方式不同,未來應會持續一段時間,政府將很難徹底執行各種非藥物預防措施,如,隔離、宵禁、關閉市場及學校、限制集會人數。
在許多人口稠密的大城市,社交距離並不可行;因非正式就業很常見,停工所帶來的社會及經濟衝擊將很嚴重。因此,檢測措施是緩解經濟及社會衝擊、集中社會衝擊、使介入更具針對性的關鍵。
但在整個非洲做檢測、追蹤、及照護,並非易事,急需各國政府及捐助者的資金贊助。檢測試劑及消耗品的供應有限,難以有效提升量能,PCR製造商亦無法快速提升產能。
歐洲國家仰賴國際捐助購買試紙、試劑、測試盒、及其他產品,在採購上亦遭遇瓶頸,尤其有些平台僅某些地區可購得。
分配稀少物資的倫理問題通常發生在國家內部,而非國家之間,WHO的國際衛生條例及Pandemic Influenza Framework通常不適用。政府有責任保護其公民,但,必須公平。
全球資源合理分配仰賴國際政治,可預期有些國家將被排除在市場之外,因此,政治上的號召是必要的,但目前大國之間仍無共識。就診斷、個人防護裝備、及疫苗與治療的投資,現在講克服地區產量及及減少對外國產品的依賴,為時已晚。
以往的經驗顯示,政府可激勵生產,但國際間的合作對確保融資及技術移轉非常重要,政府與廠商間的合作,更能發揮影響力。(「財團法人國家衛生研究院」莊淑鈞博士 摘要整理 ➥http://forum.nhri.org.tw/covid19/virus/j_translate/j930/)
📋 Access to lifesaving medical resources for African countries: COVID-19 testing and response, ethics, and politics (2020/05/07)+中文摘要轉譯
■ Author:
Matthew M Kavanagh, Ngozi A Erondu, Prof Oyewale Tomori, et al.
■ Link:
(The Lancet) https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31093-X/fulltext
🔔豐富的學術文獻資料都在【論壇COVID-19學術專區】
■ http://forum.nhri.org.tw/covid19/
#2019COVID19Academic
衛生福利部
疾病管制署 - 1922防疫達人
疾病管制署
國家衛生研究院-論壇
medical ethics中文 在 國家衛生研究院-論壇 Facebook 的最佳貼文
「Epidemiologic and Clinical Characteristics of Novel Coronavirus Infections Involving 13 Patients Outside Wuhan, China(2020/02/07)+中文摘要轉譯」
➥中文摘要轉譯:
截至2/4日,北京報告13例,大多為年輕健康人。症狀輕微且無人死亡。與過去報導一致,健康人感染後預後較佳。
註:初期流行病學易有偏誤,不可推估大流行時狀況。(財團法人國家衛生研究院-郭書辰醫師整理)
➥In December 2019, cases of pneumonia appeared in Wuhan, China. The etiology of these infections was a novel coronavirus (2019-nCoV),1,2 possibly connected to zoonotic or environmental exposure from the seafood market in Wuhan. Human-to-human transmission has accounted for most of the infections, including among health care workers.3,4 The virus has spread to different parts of China and at least 26 other countries.1 A high number of men have been infected, and the reported mortality rate has been approximately 2%, which is lower than that reported from other coronavirus epidemics including severe acute respiratory syndrome (SARS; mortality rate, >40% in patients aged >60 years)5 and Middle East respiratory syndrome (MERS; mortality rate, 30%).6 However, little is known about the clinical manifestations of 2019-nCoV in healthy populations or cases outside Wuhan. We report early clinical features of 13 patients with confirmed 2019-nCoV infection admitted to hospitals in Beijing.
「Methods」
Data were obtained from 3 hospitals in Beijing, China (Beijing Tsinghua Changgung Hospital, School of Medicine, Tsinghua University [8 patients], Beijing Anzhen Hospital, Capital Medical University [4 patients], and College of Respiratory and Critical Care Medicine, Chinese PLA General Hospital [1 patient]). Patients were hospitalized from January 16, 2020, to January 29, 2020, with final follow-up for this report on February 4, 2020. Patients with possible 2019-nCoV were admitted and quarantined, and throat swab samples were collected and sent to the Chinese Center for Disease Control and Prevention for detection of 2019-nCoV using a quantitative polymerase chain reaction assay.3 Chest radiography or computed tomography was performed. Data were obtained as part of standard care. Patients were transferred to a specialized hospital after diagnosis. This study was approved by the ethics commissions of the 3 hospitals, with a waiver of informed consent.
「Results」
The median age of the patients was 34 years (25th-75th percentile, 34-48 years); 2 patients were children (aged 2 years and 15 years), and 10 (77%) were male. Twelve patients either visited Wuhan, including a family (parents and son), or had family members (grandparents of the 2-year-old child) who visited Wuhan after the onset of the 2019-nCoV epidemic (mean stay, 2.5 days). One patient did not have any known contact with Wuhan.
Twelve patients reported fever (mean, 1.6 days) before hospitalization. Symptoms included cough (46.3%), upper airway congestion (61.5%), myalgia (23.1%), and headache (23.1%) (Table). No patient required respiratory support before being transferred to the specialty hospital after a mean of 2 days. The youngest patient (aged 2 years) had intermittent fever for 1 week and persistent cough for 13 days before 2019-nCoV diagnosis. Levels of inflammatory markers such as C-reactive protein were elevated, and numbers of lymphocytes were marginally elevated (Table).
Four patients had chest radiographs and 9 had computed tomography. Five images did not demonstrate any consolidation or scarring. One chest radiograph demonstrated scattered opacities in the left lower lung; in 6 patients, ground glass opacity was observed in the right or both lungs (Figure). As of February 4, 2020, all the patients recovered, but 12 were still being quarantined in the hospital.
➥Author: De Chang, Minggui Lin, Lai Wei, et al.
➥Link: (JAMA) https://jamanetwork.com/journals/jama/fullarticle/2761043
衛生福利部
疾病管制署 - 1922防疫達人
疾病管制署
國家衛生研究院-論壇
#2019COVID19Academic
medical ethics中文 在 コバにゃんチャンネル Youtube 的最佳解答
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medical ethics中文 在 大象中醫 Youtube 的精選貼文
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medical ethics中文 在 Medical ethics-推薦/討論/評價在PTT、Dcard、IG整理一次看 的推薦與評價
Medical ethics-推薦/討論/評價在PTT、Dcard、IG整理一次看|,另外有Medical ethics,medical ethics中文,4 principles of medical ethics,medical ethics四原則相關 ... ... <看更多>