著者

伊東 隆雄

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.20, pp.30-42, 2002-11-10 (Released:2018-02-01)

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There have been many discussions, from various positions, about what kind of care is needed with regards to terminal care for the elderly with dementia. Although it is generally thought that extraordinary treatment and care are not necessary, in reality, there is a marked tendency for excessive treatment to be performed in our country, because most physicians have difficulty accepting natural death. This is due to many physicians' strong belief that the death of a patient means a defeat for medical treatment. The elderly with dementia will not die by the disease directly, but from a complication such as pneumonia. Therefore, keeping the patient from such a complication extends a patient's life for a longer period of time. The situation of the elderly with dementia is reminiscent of the Struldbruggs in "Gulliver's Travels". In this story, these immortals must live eternally and cannot die even though they age with dementia. Furthermore, endless life-prolonging is not the purpose of terminal care. Certainly, the intellectual faculties of the elderly with dementia weaken, but, they continue to be able to maintain their emotional faculties when interacting with others. Such coexistence and feelings of emotion are basic of care and are not invasive conduct. If the medical care provider accepts the patient's death and is sympathetic to them, it is thought that appropreate medical treatment and care should be carried out naturally.