Christian R Ntizimira, Mary Dunne, Smriti Rana, Pascal Birindabagabo
{"title":"End-of-life care needs decolonising","authors":"Christian R Ntizimira, Mary Dunne, Smriti Rana, Pascal Birindabagabo","doi":"10.1136/bmj.q2810","DOIUrl":null,"url":null,"abstract":"Rich knowledge and practices of community and family based care for dying people in formerly colonised countries should inform a reimagination of palliative care globally, say Christian R Ntizimira and colleagues End-of-life care existed long before modern medical practice. The perspectives of formerly colonised countries can help to create more inclusive and culturally sensitive end-of-life care worldwide that respects diverse attitudes to death and dying. Traditional end-of-life approaches in many communities include practices for spiritual, emotional, and physical healing—in South Africa, for example, traditional healers with a deep understanding of local customs and beliefs provide psychological, cultural, and spiritual care.1 From the mid-20th century, however, Cecily Saunders’s approach to palliative care quickly came to dominate international discourse.23 The imposition of Eurocentric models of palliative care in formerly colonised countries has marginalised local cultural values and practices related to dying, death, grieving, and community, with adverse results: international standards in palliative care fail to incorporate the values and needs of patients and families in diverse cultural settings, perpetuating social injustice.4 Pain management guidelines, for example, often prioritise pharmacological solutions over traditional …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"24 1","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"The BMJ","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1136/bmj.q2810","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
Abstract
Rich knowledge and practices of community and family based care for dying people in formerly colonised countries should inform a reimagination of palliative care globally, say Christian R Ntizimira and colleagues End-of-life care existed long before modern medical practice. The perspectives of formerly colonised countries can help to create more inclusive and culturally sensitive end-of-life care worldwide that respects diverse attitudes to death and dying. Traditional end-of-life approaches in many communities include practices for spiritual, emotional, and physical healing—in South Africa, for example, traditional healers with a deep understanding of local customs and beliefs provide psychological, cultural, and spiritual care.1 From the mid-20th century, however, Cecily Saunders’s approach to palliative care quickly came to dominate international discourse.23 The imposition of Eurocentric models of palliative care in formerly colonised countries has marginalised local cultural values and practices related to dying, death, grieving, and community, with adverse results: international standards in palliative care fail to incorporate the values and needs of patients and families in diverse cultural settings, perpetuating social injustice.4 Pain management guidelines, for example, often prioritise pharmacological solutions over traditional …
Christian R Ntizimira和他的同事们说,在前殖民地国家对垂死的人进行基于社区和家庭的护理的丰富知识和实践应该为全球对姑息治疗的重新想象提供信息。前殖民地国家的观点可以帮助在全世界建立更具包容性和文化敏感性的临终关怀,尊重对死亡和临终的不同态度。在许多社区,传统的临终治疗方法包括精神、情感和身体治疗——例如,在南非,对当地习俗和信仰有深刻理解的传统治疗师提供心理、文化和精神护理然而,从20世纪中期开始,塞西莉·桑德斯的姑息治疗方法迅速主导了国际讨论在前殖民地国家,以欧洲为中心的姑息治疗模式的强加已经边缘化了当地与死亡、死亡、悲伤和社区相关的文化价值观和实践,带来了不利的结果:姑息治疗的国际标准未能纳入不同文化背景下患者和家庭的价值观和需求,使社会不公正长期存在例如,疼痛管理指南通常优先考虑药物解决方案,而不是传统的……