Dilemas sobre o fim-da-vida: informações sobre a prática médica nas UTIs

Gaudencio, Debora; Messeder, Octávio Henrique Coelho

doi:10.1590/s1413-81232011000700012

Cited by 8 publications

(7 citation statements)

References 6 publications

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“…However, a study on Brazilian Intensive Care Units (ICU) showed that intensivist professionals avoid registering some procedures, admitting that they omit information in the medical record, either for considering them unnecessary, or for fearing of punishment by the code of ethics and/or criminal law. In addition to the lack of hospital protocols of procedures regarding a patient without hope of cure, such as limitation of vital support, the absence of a clear legislation on the subject contributes to the insecurity of health professionals to carry out their records ( 18 ) , enhancing the ethical problems in environments of health care to oncological patients.…”

Section: Discussionmentioning

confidence: 99%

“…However, technological advances in medicine sometimes make inaccurate the limit of therapeutic possibilities. The devices that extend life, the extraordinary means applied to the maintenance of biological functions, the duty to make every effort to prevent death, using all means available, created the theoretical possibility to indefinitely delay the moment in which it is possible to recognize the limits of science and technology in the maintenance of life ( 18 ) .…”

Section: Discussionmentioning

confidence: 99%

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Ethical problems experienced by oncology nurses

Luz

Vargas

Schmidtt³

et al. 2015

Rev. Latino-Am. Enfermagem

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Objective: to know the ethical problems experienced by oncology nurses. Method: descriptive and exploratory study with a qualitative approach, performed in inpatient units and in chemotherapy out-patients units that provide assistance to oncological patients in two capitals in the South region of Brazil. Eighteen nurses participated in this study, selected by snowball sampling type. For data collection, semi-structured interviews were carried out, which were recorded and transcribed, and then analyzed by thematic analysis. Results: two categories were established: when informing or not becomes a dilemma - showing the main difficulties related to oncological treatment information regarding health staff, health system, and infrastructure; to invest or not - dilemmas related to finitude - showing situations of dilemmas related to pain and confrontation with finitude. Conclusion: for the effective confrontation of the ethical problems experienced by oncology nurses to occur, it is important to invest in the training of these professionals, preparing them in an ethical and human way to act as lawyers of the patient with cancer, in a context of dilemmas related mainly to the possibility of finitude.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Ethical problems experienced by oncology nurses

Luz

Vargas

Schmidtt³

et al. 2015

Rev. Latino-Am. Enfermagem

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“…Entre os familiares, 37 (37%) julgaram muito importante e 57 (57%) importante, 5 (5%) pouco importante e 1 (1%) nada importante. 6 orienta o médico a levar em consideração as vontades do paciente portador de doença incurável e terminal 6 , mas a ausência de norma específica poderia causar o temor de um ato ilícito 8 . Assim, infere-se que uma norma regulamentadora específica no âmbito da Ética Médica sobre ONR preencheria essa lacuna e traria mais segurança aos médicos.…”

Section: Metodologiaunclassified

“…. Entretanto, mesmo não sendo oficialmente reconhecida, tal conduta é adotada na prática hospitalar 7,8 ,. Em geral, são ordens médicas verbais e informais de não reanimação, emitidas sem esclarecimento e obtenção de consentimento prévio, possivelmente para evitar desgaste emocional do paciente e da família 9 .…”

Section: Introductionunclassified

Ordem de não reanimar sob a perspectiva de pacientes oncológicos e seus familiares

Eidt

Bruneri²,

Bonamigo

2017

Mundo da Saúde

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This study aims to determine the perspective of oncological patients and their families in relation to the Do Not Resuscitate Order (DNR). A questionnaire was applied to 104 oncological patients and 100 relatives, who were attended to by the oncology service of Hospital Universitário Santa Terezinha, Joaçaba, Santa Catarina, Brazil in 2014. The term DNR was unknown by 81.73% of the patients and by 82% of the relatives. After clarifying its meaning, 65.4% of patients and 67% of the relatives were favorable towards DNR in the event of cardiorespiratory failure of the patient, in the final phase of the terminal disease. A shared decision between the patients, their relatives, and the doctor was preferred by 58.65% of patients and 73% of the relatives; a decision prompted by the initiative of the doctor accompanying the treatment was preferred by 60.58% of the patients and 72% of the relatives. The execution of the DNR by the patient him/herself was considered important by 63.47% of the patients and 68.63% of the relatives, and the introduction of the DNR in Brazil was considered important by 75% of the patients and 74% of the relatives. It is concluded that the majority of the patients and relatives did not know the term "Do Not Resuscitate Order", but were favorable to the introduction of the procedure in Brazil, the personal realization through the shared decision, and that the approach would occur during medical visits. The results of this study enable us to infer the need to broaden the discussion on DNR, in the ethical social scope, in order to issue guidance to ensure the autonomy of patients who are in the terminal phases of life. dos pacientes e 67% dos familiares mostraram-se favoráveis à ONR em caso de parada cardiorrespiratória de paciente em fase final de doença terminal. A decisão compartilhada entre pacientes, familiares e médico obteve a preferência de 58,65% dos pacientes e de 73% dos familiares, por iniciativa do médico que acompanha o tratamento, segundo 60,58% dos pacientes e 72% dos familiares. A realização de sua própria ONR foi considerada importante por 63,47% dos pacientes e 68,63% dos familiares e a implantação da Ordem de não reanimar no Brasil por 75% dos pacientes e 74% dos familiares. Concluiu-se que a maioria dos pacientes e familiares desconhecia os termos ordem de não reanimar, mas era favorável à implantação do procedimento no Brasil, à realização pessoal por meio de decisão compartilhada e que a abordagem ocorresse durante as consultas médicas. Os resultados deste estudo permitem inferir a necessidade de se ampliar a discussão sobre a Ordem de Não Reanimar, no âmbito ético e social, com a finalidade de se emitir orientações para assegurar a autonomia dos pacientes que se encontram na terminalidade da vida. Keywords Palavras-chave:

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“…Outros estudos investigaram a questão da morte no contexto da UTI [11][12][13][14] . Objetivaram avaliar e verificar a conduta e decisões de médicos intensivistas diante da morte de pacientes terminais, enfocando, sobretudo, os aspectos relacionados aos dilemas suscitados pela possibilidade de controle da vida humana por meio das biotecnologias presentes no contexto da UTI.…”

Section: Introductionunclassified