*11月26日歡迎參加INDULGE演唱會

Indulge跨界美聲樂團》歌聲銷魂 ‧ 幻影迷情音樂會

時間：2011-11-26 週六 14：30
地點：台大藝文中心【雅頌坊】
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詳細資訊，請上Indulge網站:
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*人生的結局有兩種,一種有插管,一種沒插管,但最後都死掉-專訪柯文哲

人生的結局有兩種,一種有插管,一種沒插管,但最後都死掉-專訪柯文哲
日期: 2011年10月29日,六,上午12:01
http://tw.nextmedia.com/rnews/article/SecID/109/art_id/86214/IssueID/20111027
台灣葉克膜之父　柯文哲救人如救火
2011年10月27日23:29 壹電視即時
http://tw.news.yahoo.com/ 醫生還是醫死-柯文哲-人道甚於苟延殘喘
醫生還是醫死? 柯文哲：人道甚於苟延殘喘
作者： NewTalk 新頭殼 | 新頭殼 – 2011年10月28日 下午6:11

台大醫院創傷部主任柯文哲今(28)日在優質新聞發展協會的「優沙龍」演講時指出，現代醫療科技進步超乎想像，能使病患延續生命不是問題，但有時也讓一些命危的病患苟延殘喘地活著，這種病人痛苦的過程，讓他認為，對重症病患的醫療，一切首重「人道」。

柯文哲素有台灣「葉克膜權威」之稱，曾經治療邵曉玲、星星王子等知名人物。台大醫院至今已有1600名病患，曾採用葉克膜ECMO延續生命，由於因葉克膜而聲名大噪，他開玩笑地說，有些病患還以為他的名字叫「葉克膜」。

柯文哲表示，當醫生的目的，在於解除人的痛苦，但他半開玩笑地說：我們和ICU(加護病房,Intensive Care Unit)的病人無怨無仇，卻讓他們「不得好死」。他說，今日醫療科技的進步雖然早已超乎常人想像，但醫療器械延續重症病患的生命，卻同時讓痛苦的病人苟延殘喘的活著。

他舉前台塑董事長王永慶為例，指他生前一定有做好事，因為他死在美國是「善終」，如果在台灣，長庚醫師一定全力以赴，拼命幫他裝葉克膜，雖然會延長活的時間，卻可能會「死得很慘。」他認為，台灣人對於生死學，還要再教育。

柯文哲對於他一手設立的台大的5C-7D病房，認為是他醫師生涯中最得意的政績，這個他稱為「德蕾莎病房」專收病情嚴重，卻無門診可收的重症病患。柯文哲說，有一名女子帶著滿腹積水的父親求醫，卻因命已垂危而遭門診拒收，最後在心急如焚的女兒要求下被收到5C-7D病房；4個小時後，她父親終究不敵病魔離世，女兒推著她的遺體出來經過醫護櫃台時，突然下跪向醫護人員磕頭，她感謝的說：「謝謝你們沒讓我爸爸死在走廊上。」

柯文哲說，要讓沒錢、沒勢的病人也有機會被醫院收容，他並且自嘲，5C-7D病房是「全台大最爛的病房」，但「兩年來都未接過投訴」。

「醫師最大的敵人是讓病人死亡，還是使病人受苦？」柯文哲表示，醫師醫「生」不醫死，並以救人為天賦，卻沒有人教醫護人員要如何面對死亡，以及如何面對病人救不活的情況。

他說，其實台灣的醫護人員也很怕看到「死亡」，每當病患心跳數開始降低時，醫護人員往往二話不說，趕緊施打強心劑或其他急救措施，而家屬亦不捨其至親離世，因此都會要求醫護人員搶救，「有時(心肺復甦術CPR)連肋骨都壓斷了，家屬才於心不忍地喊停。」

柯文哲指出，台灣醫師有兩個「不知道」，其一為「病人的死期」，除了癌症末期等疾病外，根據美國賓州大學的研究，有一半的患者在死亡前7天，都很難預測他們的死期，因此在醫療科技日漸發達之際，須要有「面對死亡」的認知，醫療界也需要更重視安寧療護，以及加強學校與社會的生死學教育。

醫師第二個「不知道」，在於「醫師不知道如何和家屬溝通」，柯文哲認為，「除了病人該治療，家屬也應該接受治療」，現代的醫師開刀、健保等都有錢賺，唯獨「和家屬溝通」這件事沒錢可賺，因此醫生往往就放棄了和家屬的溝通。此外，醫師如果想要向無專業醫療知識的病患家屬利用醫療手段敲詐，其實家屬是無從抵抗的。

柯文哲表示，醫師應該要擁有相當高的倫理道德，把醫師當作社會公益事業來做，「如果病人會活，就要對病人好，如果病人活不成，就要盡力安撫家屬」。

柯文哲也指出，台灣的醫療資源分布不平均，可說是個「落後國家」。他指出，台灣健保問題是「政治、經濟」的問題，每個人因錢與勢的差異，導致待遇不同。有關台灣醫療資源分布的區域差異，例如台東人與台北人繳交費率相同的健保費，但根據衛生署國民健康局日前公布的調查，台東居民的平均壽命竟比台北人少了約8年，因此「人權需進步」。

柯文哲認為，「生、老、病、死」如同「春、夏、秋、冬」四季，醫生是「人」不是「神」，醫學也有其極限，無法違抗這些定律，當醫師只需盡力讓人「活得好看點」，就是一種功德。

*金鐘獎入圍的蓮花基金會公益廣告善終篇

2011年10月21日金鐘獎當天播放入圍的蓮花基金會公益廣告善終篇
http://www.youtube.com/watch?v=uDuKksW8rb8

*愛滋器捐掀起白色巨塔風暴:運用人性化科技建立更安全的醫療環境

愛滋器捐掀起白色巨塔風暴:運用人性化科技建立更安全的醫療環境
陳榮基
消費者報導366:2011年10月,5-8頁

*保護病人隱私，健保IC卡比病歷更安全保密

保護病人隱私，健保IC卡比病歷更安全保密
陳榮基

今年8月發生的 [臺大疏失5人移植愛滋器官]震驚全國的重大醫療疏失案件，至今尚未落幕。衛生署雖做了對台大醫院及成大醫院的罰款及對臺大負責器官移植指揮作業的柯文哲醫師交付臺北市醫事懲戒委員會論處，被醫界認為是沒有擔當的卸責做法。也沒看到衛生署及器官移植中心對各界指出的作業程序(SOP)漏洞，有何具體改正或修訂！其實此次事件最大的SOP漏洞，應是健保IC卡中沒有註記愛滋病HIV診斷之資料。這個漏洞的責任是衛生署及健保局，難怪衛生署不談這個漏洞如何修補(應該馬上修補！)卻拿多年來對推展器官移植貢獻最多的柯醫師開刀，醫界已經有人為柯醫師畫出一張「賽德柯巴萊」的悲壯畫面了。看到學生落此困境，我也要落淚。
我國於1990年12月17日訂定<後天免疫缺乏症候群防治條例>，經過五次修訂，予2007年07月11日公布新版，更名為「人類免疫缺乏病毒傳染防治及感染者權益保障條例」。
本法第4條「感染者之人格與合法權益應受尊重及保障，不得予以歧視，拒絕其就學、就醫、就業、安養、居住或予其他不公平之待遇。」，
第11條「有下列情形之一者，應事先實施人類免疫缺乏病毒有關檢驗：一、
採集血液供他人輸用。二、製造血液製劑。三、施行器官、組織、體液或細胞移植。前項檢驗呈陽性反應者，不得使用。醫事機構對第一項檢驗呈陽性反應者，應通報主管機關。第一項第一款情形，有緊急輸血之必要而無法事前檢驗者，不在此限。」
第12條明訂：「感染者有提供其感染源或接觸者之義務；就醫時，應向醫事人員告知其已感染人類免疫缺乏病毒。」根據第4條，感染者提供感染事實後，醫事機構及醫事人員不得拒絕提供服務。 據此，愛滋病人就醫時，即應據實向醫師報告病情，使醫師可以即時做出明確診斷及處置，醫師當然應將診斷紀錄予病歷(包括紙本及電子病歷)，做為後續診療的重要參考。此時亦應該遵照醫療常規將該資訊輸入予健保IC卡內，使後續參與診治的其他醫師也可瞭解病情。反對人士以為IC卡輸入HIV資訊，容易洩密。這是一般人不明瞭IC卡的閱讀程序所致。IC卡中的基本資料，如姓名生日地址及器捐或選擇安寧緩和醫療(DNR)意願，只要插卡予讀卡機，即可閱覽。但是病人的就醫紀錄診斷檢查及用藥等醫療資訊，必須同時插入醫師卡，並輸入醫師六位數密碼，才可閱覽。其保密程度，遠比一本病歷嚴格多了，安全多了。
第14條：「主管機關、醫事機構、醫事人員及其他因業務知悉感染者之姓名及病歷等有關資料者，除依法律規定或基於防治需要者外，對於該項資料，不得洩漏。」醫師本來就應遵守保護病人隱私的倫理義務及法律規範。
第15條：「醫事人員除因第十一條第一項規定外，應經當事人同意及諮詢程序，始得抽取當事人血液進行人類免疫缺乏病毒檢查。」這條規定，使醫師診療上受到限制，當病人不同意時，或病人已昏迷無法表示同意時，可能延誤診療時機。
當然，病人HIV陽性者，健保卡內如果做註記，讓處理捐贈器官的醫院的醫師，可以先從健保卡上，查出HIV陽性的訊息，就不會再做捐獻的動作了。如果器捐中心，也有全國HIV陽性者的資料的登錄，或可即時向衛生機構連線查詢，安全的門閥就更多了。主張保護病人資訊的人士，擔心HIV資訊的透露，會讓病人受到歧視，但是像這次的疏失，造成5個接受移植的病人及數十名愛心救人的醫護人員受害，孰輕孰重，社會應可透過討論來做抉擇。請社會人士不要再反對將重大疾病的診斷註記予IC卡，請醫界發揮視病猶親的精神，愛護與善待每一位病人，包括愛滋病人，並善待我們的醫療同仁。也請衛生署及健保局，不要一錯再錯，趕快將HIV資訊列入必須做IC卡註記的資料。確保為國家社會奉獻的醫療人員的安全，並杜絕器官移植再發生類似的重大失誤。
(本文也登錄予醫聲論壇http://www.doctorvoice.org/ http://doctorvoice.org/viewtopic.php?f=217&t=64956&sid=30c44db7db846224c442da4315129902 )

Hippocratic oath/Declaration of Geneva/Physician's oath

Hippocrates(ca.460BC-ca.370BC)希臘醫聖希波克拉底

12世紀拜占庭希波克拉底誓言(Byzantine manuscript of the Hippocratic oath)以十字架樣呈現.


以下文獻轉載自Wikipedia:
Hippocratic Oath (Modern version)
A widely used modern version of the traditional oath was penned in 1964 by Dr. Louis Lasagna, former Principal of the Sackler School of Graduate Biomedical Sciences and Academic Dean of the School of Medicine at Tufts University:[8]
I swear to fulfill, to the best of my ability and judgment, this covenant:
I will respect the hard-won scientific gains of those physicians in whose steps I walk, and gladly share such knowledge as is mine with those who are to follow.
I will apply, for the benefit of the sick, all measures [that] are required, avoiding those twin traps of overtreatment and therapeutic nihilism.
I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon's knife or the chemist's drug.
I will not be ashamed to say "I know not", nor will I fail to call in my colleagues when the skills of another are needed for a patient's recovery.
I will respect the privacy of my patients, for their problems are not disclosed to me that the world may know. Most especially must I tread with care in matters of life and death. If it is given to me to save a life, all thanks. But it may also be within my power to take a life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty. Above all, I must not play at God.
I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person's family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick.
I will prevent disease whenever I can, for prevention is preferable to cure.
I will remember that I remain a member of society with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm.
If I do not violate this oath, may I enjoy life and art, respected while I live and remembered with affection thereafter. May I always act so as to preserve the finest traditions of my calling and may I long experience the joy of healing those who seek my help.

The original Declaration of Geneva reads: (1948) / Physician's Oath
At the time of being admitted as a Member of the medical profession:
• I solemnly pledge to consecrate my life to the service of humanity
• I will give to my teachers the respect and gratitude which is their due;
• I will practice my profession with conscience and dignity;
• The health and life of my patient will be my first consideration;
• I will respect the secrets which are confided in me;
• I will maintain by all means in my power, the honor and the noble traditions of the medical profession;
• My colleagues will be my brothers;
• I will not permit considerations of religion, nationality, race, party politics or social standing to intervene between my duty and my patient;
• I will maintain the utmost respect for human life, from the time of its conception, even under threat, I will not use my medical knowledge contrary to the laws of humanity;
• I make these promises solemnly, freely and upon my honor.

Physician's Oath (2002)
At the time of being admitted as a member of the medical profession:
• I solemnly pledge myself to consecrate my life to the service of humanity;
• I will give to my teachers the respect and gratitude which is their due;
• I will practice my profession with conscience and dignity; the health of my patient will be my first consideration;
• I will maintain by all the means in my power, the honor and the noble traditions of the medical profession; my colleagues will be my brothers;
• I will not permit considerations of religion, nationality, race, party politics or social standing to intervene between my duty and my patient;
• I will maintain the utmost respect for human life from the time of conception, even under threat, I will not use my medical knowledge contrary to the laws of humanity;
• I make these promises solemnly, freely and upon my honor.

Citation:
• Declaration of Geneva (1948). Adopted by the General Assembly of World Medical Association at Geneva Switzerland, September 1948.

(Revised 06 June 2002)

希波克拉提斯宣言（The Hippocratic Oath)
希波克拉提斯（Hippocrates，B.C.460 - 377，享年 93歲 ）出生於寇斯島（Kos）。希波克拉提斯直接傳承了愛斯科勒皮歐斯對病患盡心盡力救助的仁愛胸懷（古希臘 神話的名醫，Asklepios， 由於救人無數致使人間擁擠、冥界空盪，因而遭受處死之罰），但又自創個人的思想體系。愛斯科勒皮歐斯對希波克拉提斯的影響相當大，希波克拉提斯特別強調「不可傷人乃為醫師之天職」，這個理 念也成為醫學倫理觀最主要的中心思想。

I SWEAR by Apollo the physician, and Aesculapius, and Health, and All-heal, and all the gods and goddesses, that, according to my ability and judgment, I will keep this Oath and this stipulation to reckon him who taught me this Art equally dear to me as my parents, to share my substance with him, and relieve his necessities if required; to look upon his offspring in the same footing as my own brothers, and to teach them this art, if they shall wish to learn it, without fee or stipulation; and that by precept, lecture, and every other mode of instruction, I will impart a knowledge of the Art to my own sons, and those of my teachers, and to disciples bound by a stipulation and oath according to the law of medicine, but to none others. I will follow that system of regimen which, according to my ability and judgment, I consider for the benefit of my patients, and abstain from whatever is deleterious and mischievous. I will give no deadly medicine to any one if asked, nor suggest any such counsel; and in like manner I will not give to a woman a pessary to produce abortion. With purity and with holiness I will pass my life and practice my Art. I will not cut persons laboring under the stone, but will leave this to be done by men who are practitioners of this work. Into whatever houses I enter, I will go into them for the benefit of the sick, and will abstain from every voluntary act of mischief and corruption; and, further from the seduction of females or males, of freemen and slaves. Whatever, in connection with my professional practice or not, in connection with it, I see or hear, in the life of men, which ought not to be spoken of abroad, I will not divulge, as reckoning that all such should be kept secret. While I continue to keep this Oath unviolated, may it be granted to me to enjoy life and the practice of the art, respected by all men, in all times! But should I trespass and violate this Oath, may the reverse be my lot!


Source:
Hippocrates, Works trans., Francis Adams (New York; Loeb) vol. I, 299-301.
古希臘的醫學倫理觀

The Declaration of Geneva

Adopted by the General Assembly of the World Medical Association at Geneva in 1948 and amended by the 22d World Medical Assembly at Sydney in 1968, the Declaration Of Geneva was one of the first and most important actions of the Association. It is a declaration of physicians' dedication to the humanitarian goals of medicine, a declaration that was especially important in view of the medical crimes which had just been committed in Nazi Germany. The Declaration of Geneva was intended to update the Oath of Hippocrates, which was no longer suited to modern conditions.

At the time of being admitted as a

member of the Medical Profession:

I solemnly pledge myself to consecrate

my life to the service of humanity;

I will give to my teachers the respect

and gratitude which is their due;

I will practise my profession with

conscience and dignity;

The health of my patient will be my

first consideration;

I will respect the secrets which are

confided in me, even after the patient has died;

I will maintain by all the means in my power,

the honour and the noble traditions of the

medical profession;

My colleagues will be my brothers;

I will not permit consideration of religion,

nationality, race, party; politics or social

standing to intervene between my duty and my patient;

I will maintain the utmost respect for human life

from its beginning even under threat and I will not

use my medical knowledge contrary to the laws of humanity;

I will make these promises solemnly,

freely and upon my honour.

Daily Prayer of a Physician
("Prayer of Maimonides" attributed to Moses Maimonides, a twelfth-century Jewish physician in Egypt, but probably written by Marcus Herz, a German physician. First appeared in print in 1793. Translated by Harry Friedenwald in the Bulletin of the Johns Hopkins Hospital, 1917)

Almighty God, Thou has created the human body with infinite wisdom. Ten thousand times ten thousand organs hast Thou combined in it that act unceasingly and harmoniously to preserve the whole in all its beauty the body which is the envelope of the immortal soul. They are ever acting in perfect order, agreement and accord. Yet, when the frailty of matter or the unbridling of passions deranges this order or interrupts this accord, then forces clash and the body crumbles into the primal dust from which it came.
Thou sendest to man diseases as beneficient messengers to foretell approaching danger and to urge him to avert it. Thou hast blest Thine earth, Thy rivers and Thy mountains with healing substances; they enable Thy creatures to alleviate their sufferings and to heal their illnesses. Thou hast endowed man with the wisdom to relieve the suffering of his brother, to recognize his disorders, to extract the healing substances, to discover their powers and to prepare and to apply them to suit every ill.
In Thine Eternal Providence Thou hast chosen me to watch over the life and health of Thy creatures. I am now about to apply myself to the duties of my profession. Support me, Almighty God, in these great labors that they may benefit mankind, for without Thy help not even the least thing will succeed. Inspire me with love for my art and for Thy creatures. Do not allow thirst for profit, ambition for renown and admiration, to interfere with my profession, for these are the enemies of truth and of love for mankind and they can lead astray in the great task of attending to the welfare of Thy creatures.
Preserve the strength of my body and of my soul that they ever be ready to cheerfully help and support rich and poor, good and bad, enemy as well as friend. In the sufferer let me see only the human being. Illumine my mind that it recognize what presents itself and that it may comprehend what is absent or hidden. Let it not fail to see what is visible, but do not permit it to arrogate itself the power to see what cannot be seen, for delicate and indefinite are the bounds of the great art of caring for the lives and health of Thy creatures. Let me never be absent-minded. May no strange thoughts divert my attention at the bedside of the sick, or disturb my mind in its silent labors, for great and sacred are the thoughtful deliberations required to preserve the lives and health of Thy creatures
Grant that my patients have confidence in me and my art and follow my directions and counsel. Remove from their midst all charlatans and the whole host of officious relatives and know-all nurses, cruel people who arrogantly frustrate the wisest purposes of our art and often lead Thy creatures to their death.
Should those who are wiser than I wish to improve and instruct me, let my soul gratefully follow their guidance; for vast is the extent of our art. Should conceited fools, however, censure me, then let love for my profession steel me against them, so that I remain steadfast without regard for age, for reputation, or for honor, because surrender would bring Thy creatures sickness and death.
Imbue my soul with gentleness and calmness when older colleagues, proud of their age, wish to displace me or scorn me or disdainfully teach me. May even this be of advantage to me, for they know many things of which I am ignorant, but let not their arrogance give me pain. For they are old and old age is not master of the passions. I also hope to attain old age upon this earth, before Thee, Almighty God!
Let me be contented in everything except in the great science of my profession. Never allow the thought to arise in me that I have attained to sufficient knowledge, but vouchsafe to me the strength, the leisure and the ambition ever to extend my knowledge. For art is great, but the mind of man is ever expanding.
Almighty God! Thou hast chosen me in Thy mercy to watch over the life and death of Thy creatures. I now apply myself to my profession. Support me in this greaty task so that it may benefit mankind, for without Thy help not even the least thing will succeed.

以下是台大醫學院院長魏火曜根據1948年版的翻譯:
Declaration of Geneva 醫師誓言
• 准許我進入醫業時：
• 我鄭重地保證自己要奉獻一切為人類服務。
• 我將要給我的師長應有的崇敬及感戴；
• 我將要憑我的良心和尊嚴從事醫業；
• 病人的健康應為我的首要的顧念；
• 我將要尊重所寄託於我的秘密；
• 我將要盡我的力量維護醫業的榮譽和高尚的傳統；
• 我的同業應視為我的同胞；
• 我將不容許有任何宗教、國籍、種族、政見或地位的考慮介乎我的職責和病人之間；
• 我將要最高地維護人的生命、自從受胎時起；即使在威脅之下，我將不運用我的醫業知識去違反人道。
• 我鄭重地、自主地並且以我的人格宣示以上的約言。
• Adopted by the General Assembly of the World Medical Association at Geneva, Switzerland, September 1948• 台大醫學院魏火曜院長翻譯

下面是Hitachi於2011.5.28在<醫聲論壇>發表的醫師誓言新譯版，但願不會成真。值得醫界、法界及社會各界深思！

*維護病人安全應該SOP与人性關懷並重

維護病人安全應該SOP与人性關懷並重
陳榮基(社長的話)
健康世界2011年10月刊
http://www.health-world.com.tw

歡喜迎善終 衛署推動安寧註記

歡喜迎善終 衛署推動安寧註記【記者李樹人】
衛生署、台灣安寧照顧協會昨舉辦「不做無效醫療的犧牲者，選擇安寧註記」記者會，推動安寧註記。據統計，去年國內有8萬5537名病患符合安寧緩和照護資格，但實際接受安寧照護僅1萬3273人，大部分病患來不及表達意見，造成終身遺憾。
台灣安寧照顧協會理事長陳虹汶指出，他認識一位醫學中心主任，罹癌後選擇住進安寧病房，但放不下多年治療的老病人，因此在醫院同意下回診間繼續看診，因為「即使要死，也應光榮地死於沙場」。但大部分人都只求善終，沒有痛苦有尊嚴地離開人世。
「以歡喜心來迎接善終！」醫事處長石崇良指出，台灣首創在健保IC卡註記預立選擇安寧緩和醫療意願，能夠有效保護病患免於遭受無效醫療折磨。截至上個月，全國已有8萬5000人完成安寧緩和醫療註記，提醒年滿20歲以上民眾為確保自己的醫療權利，維護生命尊嚴，應簽署預立選擇安寧緩和醫療意願，並於健保IC卡中註記。
【2011-10-08/Upaper/9版/健康】

*Group promotes hospice care

Taipei Times 台北時報 http://www.taipeitimes.com/News/taiwan/archives/2011/10/08/2003515226
Sat, Oct 08, 2011 - Page 2　News List
Group promotes hospice care
RELIEF:A hospice group urged people to sign consent forms on using services for the terminally ill to relieve loved ones of making tough decisions
Staff Writer, with CNA

Buddhist Lotus Hospice Care Foundation founding chairman Chen Rong-chi(陳榮基)wears a wristband bearing the letters DNR for “do not resuscitate” at a press conference in Taipei yesterday on the eve of World Hospice and Palliative Care Day.
Photo: Chien Jung-fong, Taipei Times

A local hospice organization urged the public yesterday — on the eve of World Hospice and Palliative Care Day — to sign consent forms indicating their willingness to use hospice care services in times of need.
Not only would this allow terminally ill patients to express how they want to live, but it would also save family members the difficulty of making decisions for their loved ones when the time comes, the Taiwan Hospice Organization said.
After signing the form, the person’s national health card will be marked with “do not resuscitate” (DNR), said Chen Hong-wen (陳虹汶), the organization’s board director.
In the event of an emergency situation, hospice staff would not perform cardiopulmonary resuscitation (CPR) on a patient, but instead opt for other medical treatments that help alleviate pain and improve quality of life, she said.
“Hospice care does not mean giving up on life or that death is imminent,” she added.
Chen said that instead of what she described as “useless” medical treatment, hospice care provides severely ill patients with holistic care, including physical and spiritual healing.
The husband of Chen Feng-yin (陳鳳鸚), a woman who chose to enter a hospice ward after suffering from a series of complications resulting from terminal lung cancer, said at the press conference: “Why not let her leave this world happily when the time comes?”
In a video clip made before her death last month, Chen said: “When I signed the consent form, I wanted my family to respect my choice.”
“Because of hospice care, I can leave the world smiling,” she said in the video, which showed her engaging in various aromatherapy sessions and music therapy at the hospice.
Taiwan has come a long way in promoting hospice care, said Shih Chung-liang (石崇良), director of the Department of Health’s Bureau of Medical Affairs. He said the government started educating the public about palliative nursing as early as 2006 and it ranked top in Asia’s end-of-life care in a recent international study.
However, while 78.7 percent of 515 family respondents to a survey conducted earlier this year said they had heard of hospice care, only 57.3 percent of 539 patient respondents said they were aware of the program.
The figures demonstrate the need for patients to understand more about the choices they have regarding different types of medical treatments, Shih said.
For that reason, the organization is inviting the public to experience hospice care today free of charge. Specialists will be present to offer consultations and consent forms will be available.
As of the end of last month, there were 87,000 people in the country who had their health insurance cards marked with the choice of hospice treatment, most of whom are aged between 50 and 59.

*健保卡註記 戴手環預約善終

健保卡註記 戴手環預約善終
【中央社╱台北7日電】2011.10.07 01:20 pm
佛教蓮花基金會董事長陳榮基在健保IC卡註記安寧緩和意願，雙手腕還有安寧療護拒絕無效急救（DNR）的手環，他今天說，希望別人能「讓我好走，不要修理我」。[這個手環由台中蓮社製作流通，今天由蓮社會長黃泳居士(思歸子)提供。]

陳榮基指出，去年經濟學人雜誌針對全球40個國家地區，評鑑「死亡品質調查─世界生命末期照護／安寧照護排名」，台灣的安寧照護雖然起步晚，但進展快，在世界排名第14，亞洲排名第1。

他表示，現在健保IC卡可以註記安寧緩和意願，他在妻子和兒子的見證下，完成註記；但是擔心萬一突發狀況被送到醫院，醫護來不及查看健保卡而「整死我」，所以最近戴上手環，提醒別人注意，不要無效急救，「不要修理我」。

這個手環上「我已簽署安寧緩和醫療意願書，我臨終不急救（DNR）」，和日前外電報導有名老婦在身上刺青（DNR），異曲同工，希望生命末期要善終，拒絕插管、電擊等無效急救醫療施在病患上的痛苦，以及家屬的無限遺憾。

截至民國100年9月止，台灣計有8萬7000名民眾簽立「預立選擇安寧緩和醫療」意願書，並已註記於健保IC卡上。中央健保局亦自98年9月1日起將安寧住院與安寧居家照護納入健保給付，已有49家醫院提供安寧住院、73家提供安寧居家服務。

行政院衛生署醫事處長石崇良指出，衛生署規定新設立的醫院須有安寧緩和醫療設備，100年4月1日起健保局展開「安寧共同照護試辦計畫」，現在一般醫院普通病房也可以提供相關照顧，53家醫院參與此計畫，不用全擠到醫學中心等候安寧病房空床。

陳榮基和台灣安寧照顧協會、中華民國安寧照顧基金會等團體，今天在10月第二個週六的「世界安寧緩和醫療日」前夕，在歌手吳昊恩的「記得說再見，積極的活，不要積極的死」的歌聲中，邀請各界參加明天在台北捷運中山站出口的安寧病房實境秀活動，關心安寧療護的推動。
【2011/10/07 中央社】

自由時報 D16 健康醫療 2011年10月8日 星期六
健保卡註記+戴「不急救」手環 預約安寧療護
▲衛生署醫事處處長石崇良（左起）、安寧照顧協會理事長陳虹汶、佛教蓮花基金會董事長陳榮基等，簽署「安寧IC健保卡註記」。 （記者簡榮豐攝）
▲佛教蓮花基金會董事長陳榮基戴「我臨終不急救DNR」手環，宣導拒絕無效醫療，確保自己的醫療權利，維護生命尊嚴。 （記者簡榮豐攝）
記者王昶閔／台北報導
昨日衛生署舉行「安寧療護全人照護」記者會，蓮花基金會董事長陳榮基教授當場秀出手環，上面載明「我已簽署安寧緩和醫療意願書 DNR 我臨終不急救」，因擔心醫護人員來不及確認健保IC卡有無註記安寧意願，因此隨身戴著手環。
保障生命尊嚴
昨日記者會上播放「向安寧英雄致敬」的影片。55歲的陳鳳鸚女士因肺腺癌轉移腦與骨骼，在生命的最後選擇安寧療護，今年6月轉入安寧病房，雖因身體疼痛、失明與失聰，卻不必歷經插管、電擊等臨終無效醫療痛苦，以舒適療法減少痛苦而善終；她的丈夫也選擇簽署安寧醫療意願，並且註記健保IC卡登錄，希望將來也能有尊嚴的離開。
陳榮基指出，去年經濟學人雜誌針對全球40個國家（包括30個經濟合作暨發展組織）所進行「死亡品質調查─世界生命末期照護與安寧照護排名」評鑑，台灣排名居亞洲第1，全球排名第14，前3名分別為英國、澳洲、紐西蘭。
台灣安寧照顧協會理事長陳虹汶表示，不少民眾至今仍對安寧療護有錯誤認知，誤以為等死或放棄治療，其實「安寧」是「拒絕」無效醫療，保障生命尊嚴的照護模式。
根據今年初公布的安寧緩和醫療條例修正案，當臨終病患已被施行心肺復甦術與維生治療後，例如氣管內插管、呼吸器、各種強心升壓藥物等，經家屬一致同意撤除且經過院方醫學倫理委員會同意認可後，醫師可據此撤除這些氣管內插管、呼吸器等無效醫療，而不是讓病人插管受罪，拖到死亡。
拒絕無效醫療
根據衛生署統計，截至100年9月止，共有8萬7000位民眾簽立「預立選擇安寧緩和醫療」意願書，並已註記於健保IC卡上。健保局也已將安寧住院與安寧居家照護納入健保給付，截至目前為止已有49家醫院提供安寧住院、73家提供安寧居家服務。
台灣安寧照顧協會的網址為www.tho.org.tw；連絡電話（02）2808-1585。

選擇安寧預約善終

[本DNR宣導手冊由台中蓮社流通]

徐鳳慈採訪撰文：選擇安寧預約善終
(原載僧伽醫護基金會會刊)

*康進和教授的[六度波羅蜜動畫]

康進和教授的[六度波羅蜜動畫]
好可愛，一定要看喔!
http://www.youtube.com/watch?v=KIhRKKKSKVA

六度：「布施、持戒、忍辱、精進、禪定、般若(淨智慧)」，以此六種德行，度脫生死煩惱河，到解脫的彼岸。

見石法師將蒞臨台大演講：翻滾吧！佛陀

台大晨曦學社/晨曦校友會演講通知
一、活動時間：10月7日(星期五)晚上7:00~9:00
二、活動地點：台灣大學綜合教室104
演講相關位置請連結下面網址:http://www.oia.ntu.edu.tw/download/Chinese_campus_map.pdf
三、活動主題：邀請見石法師蒞校演講

四、演講題目：翻滾吧！佛陀
前滾翻？後滾翻？反叛對世俗物慾的貪染，顛覆自我價值的執著！

讓我所有朋友永遠健康快樂！

{本文來自網路，原作者不詳}
我對佛說：讓我所有朋友永遠健康快樂！
佛說：只能四天！
我說:好，春天、夏天、秋天、冬天。
佛說：三天。
我說：好，昨天、今天、明天。
佛說：不行，兩天。
我說：好，晴天、雨天。
佛說：不行，就一天！
我說：好！
佛茫然問到：哪一天？
我說：在我所有朋友活著的每一天！

佛笑了……說：以後你所有朋友將天天健康快樂！

願我身邊的長輩及朋友能平平安安、順順利利、快快樂樂.

*預約安寧路

預約安寧路

台灣安寧緩和醫療的歷史與展望講座1

http://www.youtube.com/watch?v=y9kw1Ym6FYc

台灣安寧緩和醫療的歷史與展望講座2

http://www.youtube.com/watch?v=jROP-sicwgA

台灣安寧緩和醫療的歷史與展望講座3

http://www.youtube.com/watch?v=iAU9PtfCGbg

台灣安寧緩和醫療的歷史與展望講座4

http://www.youtube.com/watch?v=nbmzb5Gkk_k