Distanásia e ortotanásia: práticas médicas sob a visão de um hospital particular

Abstract

Dentre os conceitos relacionados à terminalidade da vida, encontram-se a distanásia e a ortotanásia. Distanásia significa a obstinação terapêutica para adiar a morte iminente. Ortotanásia significa morte em seu processo natural, não prolongando o tratamento. Este estudo objetivou analisar a percepção de familiares de pacientes internados acerca da ortotanásia e distanásia, avaliando a alternativa mais aceita. Trata-se de estudo transversal e observacional, no qual foram entrevistados 190 familiares por meio de questionário padronizado contendo perguntas sobre aspectos sociais e conhecimento da temática. A maioria (64,2%) manifestou preferência pela distanásia como conduta para seu familiar. Entre 122 participantes que desconheciam o significado de "estado terminal", 85,2% optariam pela distanásia. Porém, entre os que conheciam o significado, 70,9% optariam pela ortotanásia. O estudo indica a necessidade de trazer o tema para discussão da sociedade, sensibilizando-a a entender implicações individuais e coletivas do prolongamento da vida em situação de sofrimento.

Editorial

“…Several of these works expound on the subject in its most general aspects, such as how to communicate bad news in oncology 15 or the correct completion of the death certificate 16 . Others explain in detail ethical standards of professional behavior in extremely delicate situations for the patients and their families, such as the moment of the end of life [16][17][18][19][20][21][22] .…”

The person-environment relationship in the process of finitude

“…By mediating the proposal of humanization in care, it seeks to promote deinstitutionalization and provide social and family relations; factors that add safety and comfort in the process of finitude. However, it still represents a challenge for health care in Brazil, reflecting directly on health management, given the high rates of hospital treatment and high expenses for long periods of hospitalization (14)(15)(16) .…”

“…Moreover, the family often participates in this caring in an environment of sickness and apprehension along with the patient, from the initial diagnosis, which is characterized as a phase of intense suffering, until the prognosis, especially if it is identified as guarded, when there is usually denial and paralysis of those involved (17)(18)(19) . Therefore, considering the macro perspective of palliative care, it is necessary to monitor how the family deals with the disease, observing what stage of life they are in, how they are organized and the position the patient occupies in the family network, extending this care to all involved (14)(15)(16)(17)(18) .…”

“…In ICUs, suffering causes an imbalance in family and social dynamics, given that the patient is isolated, and the family is frustrated at not being nearby. On the other hand, it offers a certain security to family members, who are not committing themselves to the care, not responsible for the risks of complications related to the clinical condition, or for not suffering from the belief of helplessness and carelessness (16,18) .…”

“…Caregivers can be socially isolated, experiencing losses, including work activities, and are prone to acquire physical and psychological exhaustion, which can lead to a feeling of imprisonment, when the caregiver's life is exclusively focused on meeting the patient's demands. On the other hand, the patient lives their last days of life close to those who are important to them, without unnecessary invasive procedures, while under the care of the team of home visiting professionals (16,18,(20)(21)(22)(23) .…”