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Aganson G.I. [Socio-philosophical problems of palliative care in modern society] World of Science. Series: Sociology, Philology, Cultural Studies, 2023, Vol. 14, No. 1. Available at: https://sfk-mn.ru/PDF/20SCSK123.pdf (in Russian).

Socio-philosophical problems of palliative care in modern society

Aganson German Igorevich
«Rostov State Medical University» of the Ministry of Healthcare of the Russian Federation, Rostov-on-Don, Russia
E-mail: wargerman@gmail.com

Abstract. The relevance of comprehending the essence of palliative care from a philosophical perspective stems from the requirement, besides offering medical, psychological, and legal assistance to the patient, to address existential issues. The objective is to evaluate the quality of existing palliative care practices, identify the ethical dilemmas currently faced by the palliative care institution, and determine the direction of transformation for the moral and ethical values towards death in contemporary Russian society.

It has been established that the uniqueness of the domestic ethical and philosophical approach lies in its rejection of death and understanding of it primarily from a spiritual and moral standpoint. The focus of research has shifted from comprehending the phenomenon of death itself to the moral aspect of providing care for dying patients from the perspective of thanatology.

The study of death from such an approach, which places emphasis on the corporality aspect, necessitates seeking answers to questions such as the highest meaning of near-death suffering and whether such suffering has any value. The question of whether it is necessary to alleviate the suffering of a dying person by ending their life, when the absence of suffering is considered good, is also addressed.

It has been established that the philosophical understanding of caring for incurable patients has resulted in a shift in the interpretation of the disease and the criteria for evaluating the effectiveness of treatment. The outcome of treatment should not only be evaluated by the doctor in terms of the patient’s improved well-being, but also by the patient himself in terms of the social, economic, and psychological consequences of utilizing medical technology to treat their disease. The main principle guiding medical activities, even when a cure is not possible, should be to take all necessary measures to alleviate the patient’s suffering.

The need to expand the network of hospices to provide comprehensive support and palliative care for the dying is justified. Emphasis is placed on the importance of preserving humanistic traditions towards individuals who are deemed «economically costly» for society and do not provide material benefits. This mercy, which affirms the ideals of kindness and philanthropy, contributes to the harmonious and progressive development of society.

The author argues against the notion of euthanasia for hopeless patients as an unacceptable «right to die» for the most vulnerable categories of individuals, such as the elderly and the disabled. The conclusion reached is that the ethical approach should be at the center of the socio-philosophical problematics of palliative care, and the main focus of philosophical reflection should be finding an answer to the question of what should be considered a blessing in the individual’s transition to death.

The decision of a doctor to continue or discontinue treatment, or the choice between euthanasia and drugs to alleviate the physical suffering of a terminally ill person, should be based on ethical analysis. The article highlights the need for psychological and social adaptation not only for the sick individual but also for their relatives.

Keywords: death; the quality of life; incurable patient; hospice; euthanasia; sociophilosophical paradigm of palliative care

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