Conocimientos y actitudes sobre las instrucciones previas de los médicos de Atención Primaria y Especializada del área sanitaria de Ferrol

Ameneiros-Lago, Eugenia; Carballada-Rico, C.; Garrido-Sanjuán, J.A.

doi:10.1016/j.cali.2012.07.002

Cited by 16 publications

(3 citation statements)

References 15 publications

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“…As for health care professionals, they sometimes fail to facilitate patients' decision-making either [54], which may be an example of what we have referred to as "latent paternalism. " For different reasons (lack of knowledge or time, failure to bear in mind that completing ADs is part of their work) [55], doctors almost never provide information on ADs and seldom help patients complete them [56]. Also among the problems which ADs [47] can create are discrepancies between the patient's instructions and the opinion of family members or doctors, which may not be in line with proper clinical practice and may pave the way towards legal action.…”

Section: Paternalistic Spanish Medical Culturementioning

confidence: 99%

Why have Advance Directives failed in Spain?

et al. 2020

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Background In Spain, there has been great effort by lawmakers to put Advance Directives (ADs) into practice since 2002. At the same time, the field of bioethics has been on the rise, a discipline that has spurred debate on the right of patients to exercise their autonomy. Despite all this, the implementation of ADs can be said to have failed in Spain, because its prevalence is very low, there is a great lack of knowledge about them and they have very little impact on clinical decisions. The purpose of this article is to analyze and discuss the main reasons for the failure of ADs in Spain. Main body The main reasons why ADs have no impact on clinical practice in Spain have been fundamentally four: (1) the training of health professionals about the end of life and AD is lacking; (2) there has been no public process to increase awareness about AD, and therefore people (with the exception of specific highly sensitized groups) know little about them; (3) the bureaucratic procedure to document and implement ADs is excessively complex and cumbersome, creating a significant barrier to their application; (4) in Spain, the remnants of a paternalistic medical culture continue to exist, which causes shared decision-making to be difficult. Conclusion Due to the four reasons mentioned above, AD have not been a useful tool to help honor patients’ autonomous decisions about their future care and, therefore, they have not achieved their objective. However, despite the difficulties and problems identified, it has also been observed that health care professionals and the Spanish public have a very positive view of AD. Having identified the problems which have kept AD from being successful, strategies must be developed to help improve their implementation into the future.

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Section: Paternalistic Spanish Medical Culturementioning

confidence: 99%

Why have Advance Directives failed in Spain?

et al. 2020

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“…(21) En la misma línea, otra investigación encontró que el 82.5 % de los profesionales de atención primaria informaban que sus conocimientos sobre las directivas anticipadas eran escasos o nulos. (22) Una observación realizada en Nueva Zelanda demostró falta de conocimiento común y legal sobre las directivas anticipadas y poca experiencia en el personal sanitario. (23) Entre otras fuentes consultadas, se demostró que el 92 % del personal sanitario conoce lo qué es la directiva de las voluntades anticipadas, pero casi igual porcentaje desconoce el contenido de las leyes.…”

Section: Discussionunclassified

Directivas anticipadas en Uruguay: Incorporación a la práctica médica en el presente

Santos¹

2021

Enfermeria (Montev.)

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Introducción: La ley número 18473 de voluntades anticipadas fue promulgada en Uruguay en el año 2009, reglamentándose cuatro años después. Esto evidencia una propensión hacia la autonomía y la planificación del futuro de los enfermos. Objetivo: Determinar el conocimiento por parte de los profesionales de la salud en cuanto a la ley, su empleo en la clínica y acceso al formulario de voluntades anticipadas. Método: Investigación descriptiva, mediante una encuesta anónima a médicos uruguayos generales y especialistas en actividad, enviada por redes sociales. Resultados: Se obtuvieron 363 respuestas, con un 97 % de profesionales que atendían enfermos, un 79,5 % no habían extendido el documento y más del 50 % no tenía conocimiento de la ley. Conclusión: El conocimiento sobre las voluntades anticipadas en el cuerpo médico uruguayo es escaso y es aún más su aplicación a los pacientes.

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“…Throughout the process of CO, all parties must maintain respect to one another. Medical professionals should continue demonstrating respect towards patients, co-workers, and authorities and their respective values and decisions.xl Specifically, the professional should avoid imposition of his or her beliefs upon others and/or making value judgments [ 29 , 52 ]. On the other hand, the objecting professional must also be respected by other professionals, such that he or she not suffer psychological, occupational, or other consequences as a result of being an objector [ 48 , 53 ].…”

Section: Guidelines For the Appropriate Use Of Conscientious Objectio...mentioning

confidence: 99%

Guidelines for conscientious objection in Spain: a proposal involving prerequisites and protocolized procedure

Herreros,

Ramnath,

Santiago-Saez

et al. 2024

Philos Ethics Humanit Med

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Healthcare professionals often face ethical conflicts and challenges related to decision-making that have necessitated consideration of the use of conscientious objection (CO). No current guidelines exist within Spain’s healthcare system regarding acceptable rationales for CO, the appropriate application of CO, or practical means to support healthcare professionals who wish to become conscientious objectors. As such, a procedural framework is needed that not only assures the appropriate use of CO by healthcare professionals but also demonstrates its ethical validity, legislative compliance through protection of moral freedoms and patients’ rights to receive health care. Our proposal consists of prerequisites of eligibility for CO (individual reference, specific clinical context, ethical justification, assurance of non-discrimination, professional consistency, attitude of mutual respect, assurance of patient rights and safety) and a procedural process (notification and preparation, documentation and confidentiality, evaluation of prerequisites, non-abandonment, transparency, allowance for unforeseen objection, compensatory responsibilities, access to guidance and/or consultative advice, and organizational guarantee of professional substitution). We illustrate the real-world utility of the proposed framework through a case discussion in which our guidelines are applied.

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Conocimientos y actitudes sobre las instrucciones previas de los médicos de Atención Primaria y Especializada del área sanitaria de Ferrol

Cited by 16 publications

References 15 publications

Why have Advance Directives failed in Spain?

Why have Advance Directives failed in Spain?

Directivas anticipadas en Uruguay: Incorporación a la práctica médica en el presente

Guidelines for conscientious objection in Spain: a proposal involving prerequisites and protocolized procedure

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