2017年11月9日 星期四

broach a taboo topic, hospice, host, palliative care, Delivering Bad News

Should I Help My Patients Die?


Last year, California allowed medical aid in dying. As a palliative care specialist, how am I supposed to deal with it?

Shortly afterwards, I spoke with Attorney General Sessions in person to pass along the President’s concerns about leaks. I took the opportunity to implore the Attorney General to prevent any future direct communication between the President and me. I told the AG that what had just happened – him being asked to leave while the FBI Director, who reports to the AG, remained behind – was inappropriate and should never happen. He did not reply. For the reasons discussed above, I did not mention that the President broached the FB’s potential investigation of General Flynn.

Sandusky: Joe Paterno Never Broached Subject of Accusations
Former assistant coach says even after accusations were made, he wasn’t confronted by the school’s head coach or the charity he founded.

In the chapters ahead we will broach many of the criteria by which reasonable belief may be discriminated from unreasonable belief. But not only are the criteria not foolproof; they do not always even point in a unique direction.

Months to Live

At the End, Offering Not a Cure but Comfort

Palliative care specialists, doctors who manage patients’ last months, study how to deliver a grim prognosis, and they do it again and again.

  1. Tending or serving to palliate.
  2. Relieving or soothing the symptoms of a disease or disorder without effecting a cure.
One that palliates, especially a palliative drug or medicine.
palliatively pal'li·a'tive·ly adv.

broach 是提出來討論/辯論;

(brōch) pronunciation

tr.v., broached, broach·ing, broach·es.
    1. To bring up (a subject) for discussion or debate.
    2. To announce: We broached our plans for the new year.
  1. To pierce in order to draw off liquid: broach a keg of beer.
  2. To draw off (a liquid) by piercing a hole in a cask or other container.
  3. To shape or enlarge (a hole) with a tapered, serrated tool.
    1. A tapered, serrated tool used to shape or enlarge a hole.
    2. The hole made by such a tool.
  1. A spit for roasting meat.
  2. A mason's narrow chisel.
  3. A gimlet for tapping or broaching casks.
  4. Variant of brooch.
[Middle English brochen, to pierce, probably from broche, pointed weapon or implement, from Old French, from Vulgar Latin *brocca, from Latin broccus, projecting.]
broacher broach'er n.
SYNONYMS broach, introduce, moot, raise. These verbs mean to bring forward a point, topic, or question for consideration or discussion: broach the subject tactfully; introduce a tax bill before the legislature; an idea that was mooted before the committee; raised the problem of dropouts with the faculty.


(hōst) pronunciation
  1. One who receives or entertains guests in a social or official capacity.
  2. A person who manages an inn or hotel.
  3. One that furnishes facilities and resources for a function or event: the city chosen as host for the Olympic Games.
  4. The emcee or interviewer on a radio or television program.
  5. Biology. The animal or plant on which or in which another organism lives.
  6. Medicine. The recipient of a transplanted tissue or organ.
  7. Computer Science. A computer containing data or programs that another computer can access by means of a network or modem.
tr.v. Usage Problem, host·ed, host·ing, hosts.
To serve as host to or at: "the garden party he had hosted last spring" (Saturday Review).

[Middle English, host, guest, from Old French, from Latin hospes, hospit-.]
hostly host'ly adj.
USAGE NOTE Host was used as a verb in Shakespeare's time, but this usage was long obsolete when the verb was reintroduced (or perhaps reinvented) in recent years to mean "perform the role of a host." The usage occurs particularly in contexts relating to institutional gatherings or television and radio shows, where the person performing the role of host has not personally invited the guests. Perhaps because the verb involves a suspect extension of the traditional conception of hospitality, it initially met with critical resistance. In a 1968 survey only 18 percent of the Usage Panel accepted the usage in the sentence The Cleveland chapter will host this year's convention. Over time, however, the usage has become increasingly well established and has the useful purpose of describing the activities of one who performs the ceremonial or practical role of a host, as in arranging a conference or welcoming guests. In our 1986 survey, 53 percent of the Panelists accepted the usage in the phrase a reception hosted by the Secretary of State. The verb is less well accepted when it is used to describe the role of a performer who acts as a master of ceremonies for a broadcast or film, where the relation of the word to the notion of "hospitality" is stretched still further.

host2 (hōst) pronunciation
  1. An army.
  2. A great number; a multitude. See synonyms at multitude.
[Middle English, from Old French, from Late Latin hostis, from Latin, enemy.]

host3 also Host (hōst) pronunciation
n. Ecclesiastical
The consecrated bread or wafer of the Eucharist.

[Middle English, from Latin hostia, sacrifice.]

Education | 18.01.2011

School hospice program lifts taboo on death

A psychologist has developed an award-winning program that broaches a taboo topic with Germany school children: death. There, the kids have the freedom to ask the questions their parents are often afraid to answer.

Grandpa George has died of cancer, aged 76. He is lying in a coffin, his hands are folded. It's very quiet in the classroom of nine- and 10-year olds when the film "Willi will's wissen" - "Willi wants to know" - is being screened. But as soon as the film is over, loud talk erupts and children start making comments like, "That's how my grandpa died" or "I didn't know that coffins were lined with beautiful silk."
Often, young children are first confronted with death when their grandparents die. While they can turn to mom and dad for answers, their parents don't always know what to say because they're trying to cope with the loss themselves.
Adults fear saying the wrong thing
Psychologist Bettina Hagedorn has worked in the hospice movement in the western German city of Düren for more than 13 years. She founded the educational program Hospice Goes to School" in 2005 because "being ill-informed about death and dying causes many family members to suffer and grieve unnecessarily," she explained.
According to Hagedorn's experience, children are very open-minded and interested when it comes to talking about death.
"If no one talks with children, they develop their own fantasies - and they are more frightening than reality," she warned. "There is clearly a need for a program like this."
Kids in a classroomBildunterschrift: Großansicht des Bildes mit der Bildunterschrift: Unlike many adults, children are keen to learn about death and dyingFor the Hospice Goes to School program, a team of five trained hospice volunteers spend four hours a day for a week at an elementary school. In talking with nine- and 10-year-olds about death and dying, they dispel myths and explain facts. The children also carry out a variety of exercises that help them overcome their fears with confidence.
Most importantly, the kids are allowed to ask as many questions as they want - and they get answers.
Hagedorn's aim is for the children to learn that death is not just about sadness, but is one step in the cycle of life. In one rather lively section, they bring in photos of themselves, and discuss how they change as they age. Then the children talk about the lifecycle of butterfly and create colorful paintings.
They also learn about the use of medications, or simple facts like how fast ambulances can drive.
Easing the pain with comfort
On the last day of the course, parents are invited to join the class to see first-hand what their children have learned. The walls in the classroom are filled with paintings and drawings; off to one side there is a long row of plants that the children have been tending to all week.
"I had second thoughts, but I must say, they've done a great job," said Dietmar Hartzheim, whose daughter participated in the program. "I didn't get the impression that it was too much for the children. With the kids now learning about [death] this early, perhaps they can deal with it better later than we were able to."

The children themselves were also quite upbeat, considering the weightiness of the issue they had been dealing with all week.
Statue of a crying figureBildunterschrift: Großansicht des Bildes mit der Bildunterschrift: The children learn about mourning, sadness and comforting"I am certainly not afraid of death anymore," said one girl at the end of the five days. "For me this week was wonderful. I am no longer afraid of death."
A boy in the course said, "I'm still scared of dying because I don't know how that will be, but apart from that everything is okay."
Bettina Hagedorn knows from her own experience what it is like for children to experience the fear of a loved one dying without being able to understand what is happening.

"When I was six years old, my little brother was really ill," she explained in a soft voice. "For three days, my parents didn't know whether he was going to survive. They didn't inform my older brother and me. We had to wait outside the hospital and when they came out they were very sad, but they never told us how serious it was. It was frightening for me."
Hagedorn's efforts to keep children from having similar experiences have drawn positive attention. In 2007, the mass daily Bild am Sonntag and the German health insurance company Techniker Krankenkasse awarded it the PULSUS prize in the category "Best Health Campaign.”
Author: Wilhelmina Lyffyt
Editor: Kate Bowen

(hŏs'pĭs) pronunciation
  1. A shelter or lodging for travelers, pilgrims, foundlings, or the destitute, especially one maintained by a monastic order.古用法
  2. A program that provides palliative care and attends to the emotional and spiritual needs of terminally ill patients at an inpatient facility or at the patient's home.安寧照顧
[French, from Old French, from Latin hospitium, hospitality, from hospes, hospit-, host.]