現代醫學自20世紀以降取得了快速的發展。當英國科學家弗萊明(Alexander Fleming)於1928年發明了盤尼西林之後，人類便在醫學道路上大步向前。到了20世紀後半葉以後，醫學領域的成就更加輝煌，心肺復甦術、呼吸器、洗腎機葉克膜等、人工器官、器官移植等種種高科技設備與技術不斷地被發明，人類的生命也因此而被顯著地延長。然而，這種因醫療技術延長的生命意義究竟為何？這樣被傷害的生命末期生活品質，是不得不承受的必要之惡嗎？抑或只是對人工生命的嘲諷？於是，不僅社會上發出了許多檢討的聲浪，醫療界也開始省思。
肇因於一位照護中的末期骨癌患者的吶喊，當時身為護理師的桑德斯女士(Dam Cicely Saunders)首次省思到現代醫療方向是如何地與病人的期望背道而馳，於是在她經歷社工師的歷練並取得醫師資格後，最終於1967年創立全世界第一家專為照顧末期病人的獨立安寧「St. Christopher’s hospice」，開啟了全世界推動安寧照護的浪潮。台灣安寧照護起步相對比較慢，但是照護品質卻不亞於許多早於台灣發展的國家，一項新加坡蓮式基金會委托經濟學人雜誌調查的報告中顯示，台灣名列四十個國家生命末期照護品質全球排行榜第14名，亞洲第一名。
台灣安寧照顧協會於1995年10月7日由專業的醫師、護理師、治療師、復健師、藥師、營養師、心理治療師、社工師、神職及義工等人員所組成的服務團體，以提供正確完整之身、心、靈全人的醫療照顧。協會發展至今已是第二十個年頭，雖然取得了相當的成就，但是前方仍有許多有待克服的挑戰。
本研究擬以麥肯錫7S架構 (Mckinsey 7S framework) 模型，評估與監測台灣安寧照顧協會的內部變化與資源現況，重新定位協會核心價值及凝聚目標並嘗試尋求未來發展策略。

Modern medicine made great advances in 20 century. Penicillin, discovered by Alexander Fleming in 1928, is a remarkable achievement and has saved those people who should die of infective disease in early 20 century. More and more drugs, techniques and devices, like as CPR, mechanical ventilator, dialysis, ECMO, and other life-sustaining treatment were then evolved and prolong patient’s life significantly. However, these treatment modalities not only prolong lives and also prolong dying process. The impact of life quality of terminal disease is getting more concerned.
Hospice care is a type of care that focuses on the palliation of end-stage or terminally ill patient's pain and other symptoms, and is attending to their emotional and spiritual needs. Modern hospice services were pioneered in the 1950s by Dame Cicely Saunders and then became the mainstream of modern medicine.
Taiwan Hospice Organization, THO, founded by multidisciplinary specialist, including doctors, nurses, social workers, chaplains and volunteers, in 1995. Many hospice care related societies and foundations founded in the past 20 years and the relationship of cooperation and competition between these organizations was more and more complicated.
By the tool of Mckinsey 7S framework, this study aims to assess and monitor changes in the internal situation of THO and to understand how the organizational elements interrelated. Furthermore, we try to help identify what needs to be realigned and reinforced to improve THO performance.

目錄
論文摘要 ---------------------------------------------------------------------------------------------- I
ABSTRACT ---------------------------------------------------------------------------------------- II
誌謝 ------------------------------------------------------------------------------------------------- III
圖目錄 ----------------------------------------------------------------------------------------------- VI
表目錄 ---------------------------------------------------------------------------------------------- VII
第一章 緒論 ----------------------------------------------------------------------------------------- 1
1.1 研究背景與動機
1.2 研究的目的
第二章 文獻探討 ---------------------------------------------------------------------------------- 4
2.1 麥肯錫7S 架構模型
2.2 麥肯錫7S 架構分項探討
2.2.1 策略
2.2.2 組織結構
2.2.3 系統
2.2.4 技能
2.2.5 人員
2.2.6 風格
2.2.7 共享價值觀
第三章 安寧緩和醫療 -------------------------------------------------------------------------- 22
3.1安寧緩和醫療發展史
3.2 台灣安寧發展歷史與現況
3.2.1 歷史
3.2.2 現況
3.3競合機構-其他安寧相關非政府組織
3.3.1 安寧照顧基金會
3.3.2 台灣安寧緩和醫學學會
3.3.3 台灣安寧緩和護理學會
3.3.4 其他機構
第四章 個案研究 - 台灣安寧照顧協會 --------------------------------------------------- 42
4.1 研究方法與架構
4.2 個案分析
4.2.1 發展與現況
4.2.2 個案核心業務
4.2.3 麥肯錫7S分析結果
第五章 結論與建議 ----------------------------------------------------------------------------- 54
5.1 研究結果與分析
5.2 建議事項
第六章 參考文獻 --------------------------------------------------------------------------------- 59

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