Death is not a momentary event, but a process that every life must go through before it reaches the end. In forensic science textbooks, death is divided into three periods, namely the near-death period, the clinical death period and the biological death period. Death is manifested by the complete cessation of blood circulation and the cessation of movements such as natural life functions such as breathing and heartbeat. Until the early 20th century, breathing and cardiac arrest were used as criteria for interpreting death.
But over time, medical technology has advanced, and people's perception of death has changed. For example, patients who have stopped cardiopulmonary function still have the opportunity to sustain themselves through drug, machine, or organ transplant techniques. Modern medicine's in-depth study of the process of human death has shown that when a person's heartbeat stops, the brain, liver, kidneys and other organs do not die immediately, as long as the brain function remains intact, life activities may resume again. Brain death, on the other hand, refers to the permanent loss of whole brain function in the brainstem or above, so that the body can no longer function as a whole. Therefore, the current medical community regards brain death as the criterion for judging the death of human individuals.
Death is a process that everyone must go through. When death comes, the heartbeat stops beating, the blood slowly coagulates, the brain cells begin to die, and the body gradually becomes stiff. In addition to the changes in the body, the psychological changes near death have also begun to receive more and more attention. People's attitudes toward death are different, some people are pessimistic and afraid, afraid of losing their lives and a good life; some people try to avoid and refuse to discuss all topics related to death (most tumor patients belong to this category); Some people are relatively rational, and when death is inevitable, they can treat it objectively and arrange things for family, work and posthumous affairs. In addition to patients, healthcare workers who face terminally and dying patients directly also experience anxiety, loss, and fear. How do we face it in the final stages of life? It's a question worth thinking about for all.
With the development and progress of medicine, the aging and death process in the life process has gradually become a medical intervention subject, and how to make limited life have a higher quality is also one of the technical pursuits of medical practitioners who "never give up". At the last stop of life, there are often two situations: overtreatment and undertreatment. On the one hand, some patients continue to receive traumatic treatment and suffer additional pain until the last breath of life: on the other hand, some patients' pain and discomfort are not adequately relieved until death.
The patient's end-time period is generally 10 to 14 days (sometimes as short as 24 hours). At this stage, patients should avoid inappropriate traumatic treatment, and the doctor's work has gradually shifted from "helping the patient to recover his health" to end-of-life care aimed at "alleviating pain".
The World Health Organization's (WHO) moral definition of hospice care is: neither hastening nor delaying the arrival of death. Hospice care can alleviate the suffering of patients through comfort care, psychological support, etc., and help them correctly understand and treat death. At the same time, it also allows patients to complete the last journey of life with dignity and no regrets. The specific definition of hospice care is heavily influenced by regional cultures and traditional attitudes.
Influenced by the traditional filial piety culture, China's hospice cause started late, the education related to it is relatively lacking, and the shortage of medical staff engaged in hospice care is the key to hindering the development of hospice care. With the advent of China's aging society, the social demand for hospice care is becoming increasingly strong, and hospice care has gradually received social attention, but only about 0.7% of hospitals can provide hospice treatment services, which is difficult to meet the needs of society. But no matter what, we should gradually realize that death is the return of life, and hospice care is the progress of society, and it is respect and comfort for life.
At present, China attaches great importance to the cultivation of hospice talents, and actively carries out a variety of hospice care models, such as the family-community model, the hospice model, the "medical care + PPP* model, the "Internet + hospice" model, etc., and is committed to providing patients with more intimate protection at the end of life. Man's attitude toward death, in a sense, is also an attitude toward life. From fearing death, to accepting death, to calmly facing death, this process is a gradual process of maturity of life and thought.
Excerpt from Science World