ETHICS IN DECISIONS ABOUT THE END OF LIFE - THE IMPORTANCE OF PALLIATIVE CARE

Authors

  • Ana Dias Neto

DOI:

https://doi.org/10.25753/BirthGrowthMJ.v22.i4.9910

Keywords:

Bioethics principles, curative medicine, end-of-life decision makers, ethic, human suffering, living will, pain, palliative care, patient

Abstract

When Curative Medicine no longer has any effect on a patient’s clinical picture because his state is definitely irreversible, it becomes urgent to give assistance to anyone who is in the final stage of living. And because, quite often, this phase is preceded by enormous pain and suffering, which contributes to the loss of quality of life, the aim of Palliative Medicine is to fight it. Palliative Care exists as an interdisciplinary set directed at accompanying the terminal patient. It is an ethic, medical and psychological response to the final needs of the terminal patient. But we should never overstep the boundaries of human dignity and the patient’s choices. That is to say, it is acceptable to maintain the quality of life, but not when the means are disproportional, useless or absolutely contradict what is contemplated, for example, in the patient’s Living Will. In Portugal, Palliative Medicine has progressively gained space, both physically (through an increasing number of palliative care units through the country) and in terms of government awareness (to assure the proliferation and logistic assistance to palliative care). The aim is that the terminal patient, regardless of his economic and social conditions, has access to Palliative Medicine and be fully entitled to his right to health. The bioethics principles of Autonomy, Beneficence, Nonmaleficence and Justice sympathize with the palliative care which each patient agrees to submit to and to which he is entitled in order to maximize the benefits of the treatment and minimize its damages.

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References

Serrão D, Nunes R. Ética em Cuidados de Saúde: ética das

atitudes médicas em relação ao processo de morrer. Autor;

p. 86.

Moura C. A inevitabilidade da morte e o cuidar em fim de

vida: entre a Filosofia e a Bioética. Coisas de Ler; 2011. p.

-3.

Nunes R, Rego G, Duarte I (coord). Eutanásia e outras ques-

tões éticas no fim da vida. Coimbra: Gráfica de Coimbra 2;

p. 86 e 92.

Hall S, Petkova H, Tsouros AD, Constantini M, Higginson

IJ. Palliative Care for Older People: Better Practices. WHO.

Disponível em: http://www.euro.who.int/__data/assets/

pdf_file/0017/143153/e95052.pdf.

Brito AJSL, Rijo JMSL. Estudo jurídico da eutanásia em Por-

tugal: direito sobre a vida ou direito de viver?. Coimbra: Alme-

dina; 2000. p. 11, 13, 34, 54, 78 -9.

Mappes TA, Zembaty JS. Biomedical Ethics. 3th Ed.

MacGraw -Hill; 1991. Ch. 7, p. 398 -9.

Recomendações para a Organização de Serviços de Cuida-

dos Paliativos – ANCP 2006. Disponível em: http://www.apcp.

com.pt/uploads/recomendaesorganizaodeservios -apcp.pdf

WHO. Integrated Management of Adolescent and Adult Ill-

ness. Palliative Care: symptom management and end -of -life

care. Junho, 2004. Disponível em: http://www.who.int/hiv/

pub/imai/genericpalliativecare082004.pdf

OECD Factbook 2009: Economic, Environmental and Social

Statistics. OECD Publishing. 2009. Disponível em: http://

www.keepeek.com/Digital -Asset -Management/oecd/eco-

nomics/oecd -factbook -2009/population -aged -65 -and -over_

factbook -2009 -table4 -en

Estratégia para o Desenvolvimento do Programa Nacional de

Cuidados Paliativos. Plano da Rede Nacional de Cuidados

Continuados Integrados 2011 -2013. Unidade de Missão para

os Cuidados Continuados Integrados. Dezembro, 2010. Dis-

ponível em: http://www.rncci.min -saude.pt/SiteCollectionDo-

cuments/cuidadospaliativos_1 -1 -2011.pdf

Dec. Lei Nº 101/2006, de 6 de junho, in Drep nº 109. Série I

–A de 6/6/2006. Disponível em: www.dre.pt

Cuidados Paliativos: um Direito Humano (Carta de Praga).

Associação Portuguesa de Cuidados Paliativos. Disponível

em: http://www.apcp.com.pt/noticias/cuidados -paliativos -um-

-direito -humano -carta -de -praga.html.

SOL. Cuidados Paliativos não chegam a 10% dos pacientes

necessitados. Abril, 2013. Disponível em: http://sol.sapo.pt/

inicio/Sociedade/Interior.aspx?content_id=72488

Pessini L, Barchifontaine CP. Problemas Actuais da Bioética.

ª ed. São Paulo: Edições Loyola e Editora do Centro Univer-

sitário São Camilo; 2002. p. 257 e ss.

Gavicagogeascoa MI. Futilidade terapêutica. In: Urban CA.

Bioética Clínica. Rio de Janeiro: Revinter; 2003. Cap. 54, p.

Parecer N.º P/05/APB/06 Sobre as Directivas Antecipadas

de Vontade. Relatores: Helena Melo e Rui Nunes. Pp. 6. Dis-

ponível em http://www.apbioetica.org

Hastings Center Project Group on the Termination of Tre-

atment. Treatment Decisions for Incompetent Adults. Iden-

tifying the key decision maker and making the decision. In:

Mappes TA, Zembaty JS (ed). Biomedical Ethics. 3th Ed. New

York: MacGraw -Hill; 1991. Ch 6, p. 347 -8.

Urban CA, Simon A, Bardoe W, Silva IM. Ordens de não-

-reanimação. In: Urban CA. Bioética Clínica. Rio de Janeiro:

Revinter; 2003. Cap. 55, p. 524.

Barbosa A. Bioética e Cuidados Paliativos. In: Barbosa A,

Neto I (ed). Manual de Cuidados Paliativos. Núcleo de Cuida-

dos Paliativos, Centro de Bioética da Faculdade de Medicina

de Lisboa. 19ª Ed. Maiadouro; 2006. p. 44.

Jonsen AR. The Belmont Report: Ethical Principles and Gui-

delines for the Protection of Human Subjects of Research.

In: Jonsen AR, Veatch RM, Walters LR (ed). Source Book in

Bioethics: A Documentary History. Washington, DC: George

Town University Press; 1998. p. 22 -8.

Beauchamp TL, Childress JF. Principios de Ética Biomédica.

Barcelona: Masson; 2002.

Beauchamp TL, Childress JF. El Respeto a la Autonomia. In:

Beauchamp TL, Childress JF. Princípios de Ética Biomédica.

Barcelona: Masson; 2002. p. 113 -78.

Beauchamp TL, Childress JF. Beneficencia. In: Beauchamp

TL, Childress JF. Principios de Ética Biomédica. Barcelona:

Masson; 2002. p. 266 -7.

Beauchamp TL, Childress JF. Justicia. In: Beauchamp TL,

Childress JF. Principios de Ética Biomédica. Barcelona: Mas-

son; 2002. p. 311 -78.

Holland S. Advance Directives. In: Holland S. Bioethics: a

philosophical introduction. Cambridge: Polity Press; 2003.

Cap. 7, p. 127.

Published

2016-09-05

How to Cite

1.
Neto AD. ETHICS IN DECISIONS ABOUT THE END OF LIFE - THE IMPORTANCE OF PALLIATIVE CARE. REVNEC [Internet]. 2016Sep.5 [cited 2024Mar.19];22(4):252-6. Available from: https://revistas.rcaap.pt/nascercrescer/article/view/9910

Issue

Section

Current Perspectives in Bioethics