Direito dos pacientes às diretivas antecipadas de vontade

Abstract

Resumo Este estudo investigou o conhecimento que 55 pacientes com doenças terminais tinham sobre seu diagnóstico, prognóstico e a possibilidade de registrar seus desejos no final de vida sob a forma de diretivas antecipadas de vontade. Dos sujeitos da pesquisa, apenas um as havia registrado, e três deles, após diálogo com a pesquisadora, manifestaram interesse em formalizá-las. Os demais declararam não ter tido oportunidade de conversar sobre o tema. As decisões sobre o final da vida do enfermo invariavelmente evidenciam a subestimação de diálogo esclarecedor entre médico e paciente. Os dados do estudo sugerem que as diretivas antecipadas, embora façam parte do respeito à autonomia de vontade dos pacientes com doenças terminais, estão longe de serem efetivadas na prática, o que leva à necessidade de melhorar a comunicação entre médicos e pacientes sobre o processo de terminalidade da vida.

Can Bioethics Protect the Holders of Compromised Decisional Competence?

“…Another factor to be considered is legal uncertainty, due to the lack of specific legislation cited pre-viously, which can also lead to endless treatments and sufferings [17] that are not listed as accepted on the patient's VT.…”

Implementation of early will directives: facilities and difficulties experienced by palliative care teams

“…Contradictions may permeate communication processes established among stakeholders if health workers do not offer the possibility to address end-of-life issues or the option to establish advance directives, revealing a lack of communication between physicians, nurses, and patients (16) . In this study, however, effective communication between workers, patients, and families, was mentioned as a way to enable the establishment of advance directives, in which care is planned in such a way that future treatment and end-of-life decisions are based on the patients' expressed desires (15) , confirming dialogue can be effectively implemented among all those involved.…”

“…Giving a voice to family members is essential when patients are incapacitated (5) , however, appointing a family member or even a friend to make decisions may lead to issues permeated by affectivity, hindering the process (16) . Conflicts concerned with advance directives are challenging to handle because these are usually closely linked to values, beliefs, and the experiences of different stakeholders (19) .…”

Terminality Advance Directives and Nursing Practice in Brazil: Bioethical Issues

“…This resolution considers the probability of the patient to name a representative so his demands can be met when he can no longer pronounce them [19]. The instruction to interrupt treatments that unnecessarily prolong the life of the patient with a severe or incurable illness allowed to the doctor was already provided for in Resolution CFM 1805 of 2006 [20].…”

“…Also in Article 3, the Bill proposes that "every greater and capable person has the right to declare in advance, his or her will to receive or not certain medical treatments in the future when being in clinical condition" [20]. Article 5 of this same Bill reports that "advance directives must be met by health professionals and public or private health services, as well as by relatives, legal guardians, and the declarant's representative" [21].…”