著者

遠藤 正樹 阿萬 由起子 大倉 民江

出版者

日本医学哲学・倫理学会

雑誌

医学哲学 医学倫理 (ISSN:02896427)

巻号頁・発行日

vol.14, pp.57-68, 1996-10-01 (Released:2018-02-01)

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Medical social workers have to meet a wide range of needs of patients and their families as citizens and persons involved in the total daily medical care. Especially in transplantation treatment the existence of social workers is indispensable for helping patients with their own decisions for their own benefit from psychological and social viewpoints. In actual team medical care, it is important to promote the medical staff 's further understanding of patients with regard to the advocacy and respect of their own thinking from the standpoint of a third party. The role and importance of social workers in transplantation treatment is discussed, torough a case the authors were involved in, by examining the process of self-decisions by a patient and his family. The actual case here was a patient who, as a citizen, desired a heart transplant after many years of fighting against diastolic cardiomyopathy and succeeded in receiving it in the United States. The importance of medical social workers has not been fully recognized in Japan. As a result there is still a persistent shortsighted view that their role is no more than to exhort and persuade patients in response to their complaints. This paper discusses and tries to define the differences in roles and specialties between transplant coordinators and social workers as the key persons in transplantation treatment on the basis of the actual case and a field report on the actual heart transplant in the United States.

著者

大倉 民江

出版者

日本医学哲学・倫理学会

雑誌

医学哲学 医学倫理 (ISSN:02896427)

巻号頁・発行日

vol.13, pp.164-168, 1995-10-01 (Released:2018-02-01)

著者

奈倉 道隆 大倉 民江

出版者

日本医学哲学・倫理学会

雑誌

医学哲学 医学倫理 (ISSN:02896427)

巻号頁・発行日

vol.13, pp.115-122, 1995-10-01 (Released:2018-02-01)

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In Japan, informed consent (IC) is not carried out satisfactorily in order to improve the situation, medical social work (MSW) is essential. While the need for MSW is increasing, it is yet recognized in the medial world of japan in four of the reasons for this fact are as follow (1) Medical doctors take the initiative in the field of medicine and patients become more passive. As a result publish do not try to ask for MSW support. (2) In Japan, medicine only means diagnosis, treatment or nursing of diseases. Solution psychological or social problems of a patient are not considered medical matters, even though they may be related to disease or treatment. (3) Right now, medicine is not administered through team work, and MSW, activities which received patient asking and coordination of medical activities do not operate smoothly yet. (4) In Japan people tend to think that maintaining a good relationship is much more important than realizing their own will or desire. These four factors hinder IC. Now it is necessary to solve these problems. The solution of this problem would also bring the proper situation to make progress IC and establish MSW concretely, which would contribute to IC.