The aim of this study was to think about a problem related to clinical ethics in palliative care from clinical psychology. A male who was 70 years with terminally ill cancer received medical treatments under the COVID-19 pandemic. A family member could meet for only 15 minutes. Since there were no effective treatments, the primary care physician recommended moving to a hospital with palliative care wards or home. The patient was greatly angry and rejected its’ recommendation. The family member was very confused. The patient wanted to receive medical treatments moreover, however, his physical state was too serious because of pain or tiredness. Lastly, he chose a hospital with palliative care and died after 10 days later from hospitalization. We used the Four Topics Chart (medical indication, patient preference, well-being, contextual features) by Jonsen. There were conflicts between patient preference of receiving much more treatments and medical indication of recommendation of palliative care: respect for autonomy vs beneficence in bioethics four principal. And he might be suffered from difference between ideal and real of his death process. Clinical psychological care to express his emotion or thinking to find a way to spend his time fulfilling. A clinical psychologist may require special communication skills.
満代 安藤 (Mon,) studied this question.