Terminality Advance Directives and Nursing Practice in Brazil: Bioethical Issues

Abstract

Advance directives (ADs) are understood as the act of deciding what care the patient wants to receive in the period before death. Preserving the patient's autonomy by choosing his care guarantees human dignity during the process of dying. In Brazil, life expectancy and supportive technologies have increased, leading to growth of the number of terminally ill patients. However, there is still no legislation regulating ADs causing legal uncertainty in health professionals. Nursing professionals have the support of the Federal Nursing Council to respect the ADs, but, because it is an issue little explored, nursing professionals do not feel safe in the use of ADs, and changes in the curricula of the undergraduate courses in nursing are extremely needed, ensuring that patients have their wishes met during the dying process. Thus, this chapter deals with bioethical and legal issues involving ADs and nursing in the Brazilian context, proposing to deepen reflection and criticism on the issue and subsidies for decision-making.