Initiate or withhold invasive mechanical ventilation – an application of the four ethical principles
Autor(a) principal: | |
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Data de Publicação: | 2021 |
Outros Autores: | , |
Tipo de documento: | Artigo |
Idioma: | por |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://doi.org/10.34632/cadernosdesaude.2021.10299 |
Resumo: | Introduction: Medical decision regarding withholding treatment is a true ethical challenge. Contemplation over autonomy, beneficence, non-maleficence, and justice can guide us through this decision to reach the best possible clinical outcome. Aim: To promote a more adequate clinical decision, based on the four ethical principles. Material and Methods: Through a clinical case illustration of idiopathic pulmonary fibrosis, a reflection based on the four ethical principles about initiation or withholding of invasive mechanical ventilation was intended. For that effect, a classic review of the literature was made regarding the four ethical principles and the initiation of invasive mechanical ventilation in idiopathic pulmonary fibrosis.Discussion: After a multidisciplinary ethical and clinical reflection, it was considered that the patient would not benefit from invasive mechanical ventilation. The patient was informed of his actual state of disease and initiation of comfort measures was agreed, including high-flow oxygen therapy. Conclusion: The application of the four ethical principles gives a moral, fundamental and mutual language and structure, which should be complement with a compassive support of the family, an enlightening communication and an essential information sharing. An early follow-up by a palliative care team is of the essence. |
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Initiate or withhold invasive mechanical ventilation – an application of the four ethical principlesIniciar ou não a ventilação mecânica invasiva – uma aplicação dos quatro princípios éticosIntroduction: Medical decision regarding withholding treatment is a true ethical challenge. Contemplation over autonomy, beneficence, non-maleficence, and justice can guide us through this decision to reach the best possible clinical outcome. Aim: To promote a more adequate clinical decision, based on the four ethical principles. Material and Methods: Through a clinical case illustration of idiopathic pulmonary fibrosis, a reflection based on the four ethical principles about initiation or withholding of invasive mechanical ventilation was intended. For that effect, a classic review of the literature was made regarding the four ethical principles and the initiation of invasive mechanical ventilation in idiopathic pulmonary fibrosis.Discussion: After a multidisciplinary ethical and clinical reflection, it was considered that the patient would not benefit from invasive mechanical ventilation. The patient was informed of his actual state of disease and initiation of comfort measures was agreed, including high-flow oxygen therapy. Conclusion: The application of the four ethical principles gives a moral, fundamental and mutual language and structure, which should be complement with a compassive support of the family, an enlightening communication and an essential information sharing. An early follow-up by a palliative care team is of the essence.Introdução: A decisão médica de não iniciação de terapêutica constitui um verdadeiro desafio ético. A ponderação sobre a autonomia, beneficência, não maleficência e justiça pode guiar-nos nesta decisão para alcançar o melhor desenlace clínico possível. Objetivo: Promover a decisão clínica mais adequada, baseando-se nos quatro princípios éticos. Materiais e Métodos: Através da ilustração de um caso clínico de fibrose pulmonar idiopático, pretende-se uma reflexão sobre a iniciação ou não de ventilação mecânica invasiva. Para esse efeito, fez-se uma revisão clássica da literatura sobre os quatro princípios éticos e a instituição de ventilação mecânica invasiva na fibrose pulmonar idiopática. Discussão: Após reflexão clínica, consideramos que o Senhor J. não beneficiaria da instituição de ventilação mecânica invasiva. Informou-se o Senhor J. da sua condição de doença e concordou-se em instituir medidas de conforto, incluindo oxigénio de alto fluxo. O acompanhamento da equipa de cuidados paliativos ocorreu na fase terminal da doença. Conclusão: A aplicação dos quatro princípios éticos fornece uma linguagem e estrutura analítica moral, básica e comum, que deve ser complementada por um suporte compassivo dos familiares, comunicação esclarecedora e partilha de informação essencial. O acompanhamento precoce por uma equipa de cuidados paliativos é essencial.Universidade Católica Portuguesa2021-07-01info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttps://doi.org/10.34632/cadernosdesaude.2021.10299https://doi.org/10.34632/cadernosdesaude.2021.10299Cadernos de Saúde; Vol 13 No 2 (2021); 56-61Cadernos de Saúde; v. 13 n. 2 (2021); 56-612795-43581647-055910.34632/cadernosdesaude.2021.13.2reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPporhttps://revistas.ucp.pt/index.php/cadernosdesaude/article/view/10299https://revistas.ucp.pt/index.php/cadernosdesaude/article/view/10299/10591Direitos de Autor (c) 2021 Nuno Caires, João Paulo Correia, Corinna Lohmannhttp://creativecommons.org/licenses/by/4.0info:eu-repo/semantics/openAccessCaires, NunoCorreia, João PauloLohmann, Corinna2024-01-31T10:06:21Zoai:ojs.revistas.ucp.pt:article/10299Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T20:33:13.288039Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Initiate or withhold invasive mechanical ventilation – an application of the four ethical principles Iniciar ou não a ventilação mecânica invasiva – uma aplicação dos quatro princípios éticos |
title |
Initiate or withhold invasive mechanical ventilation – an application of the four ethical principles |
spellingShingle |
Initiate or withhold invasive mechanical ventilation – an application of the four ethical principles Caires, Nuno |
title_short |
Initiate or withhold invasive mechanical ventilation – an application of the four ethical principles |
title_full |
Initiate or withhold invasive mechanical ventilation – an application of the four ethical principles |
title_fullStr |
Initiate or withhold invasive mechanical ventilation – an application of the four ethical principles |
title_full_unstemmed |
Initiate or withhold invasive mechanical ventilation – an application of the four ethical principles |
title_sort |
Initiate or withhold invasive mechanical ventilation – an application of the four ethical principles |
author |
Caires, Nuno |
author_facet |
Caires, Nuno Correia, João Paulo Lohmann, Corinna |
author_role |
author |
author2 |
Correia, João Paulo Lohmann, Corinna |
author2_role |
author author |
dc.contributor.author.fl_str_mv |
Caires, Nuno Correia, João Paulo Lohmann, Corinna |
description |
Introduction: Medical decision regarding withholding treatment is a true ethical challenge. Contemplation over autonomy, beneficence, non-maleficence, and justice can guide us through this decision to reach the best possible clinical outcome. Aim: To promote a more adequate clinical decision, based on the four ethical principles. Material and Methods: Through a clinical case illustration of idiopathic pulmonary fibrosis, a reflection based on the four ethical principles about initiation or withholding of invasive mechanical ventilation was intended. For that effect, a classic review of the literature was made regarding the four ethical principles and the initiation of invasive mechanical ventilation in idiopathic pulmonary fibrosis.Discussion: After a multidisciplinary ethical and clinical reflection, it was considered that the patient would not benefit from invasive mechanical ventilation. The patient was informed of his actual state of disease and initiation of comfort measures was agreed, including high-flow oxygen therapy. Conclusion: The application of the four ethical principles gives a moral, fundamental and mutual language and structure, which should be complement with a compassive support of the family, an enlightening communication and an essential information sharing. An early follow-up by a palliative care team is of the essence. |
publishDate |
2021 |
dc.date.none.fl_str_mv |
2021-07-01 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://doi.org/10.34632/cadernosdesaude.2021.10299 https://doi.org/10.34632/cadernosdesaude.2021.10299 |
url |
https://doi.org/10.34632/cadernosdesaude.2021.10299 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.relation.none.fl_str_mv |
https://revistas.ucp.pt/index.php/cadernosdesaude/article/view/10299 https://revistas.ucp.pt/index.php/cadernosdesaude/article/view/10299/10591 |
dc.rights.driver.fl_str_mv |
Direitos de Autor (c) 2021 Nuno Caires, João Paulo Correia, Corinna Lohmann http://creativecommons.org/licenses/by/4.0 info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Direitos de Autor (c) 2021 Nuno Caires, João Paulo Correia, Corinna Lohmann http://creativecommons.org/licenses/by/4.0 |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Universidade Católica Portuguesa |
publisher.none.fl_str_mv |
Universidade Católica Portuguesa |
dc.source.none.fl_str_mv |
Cadernos de Saúde; Vol 13 No 2 (2021); 56-61 Cadernos de Saúde; v. 13 n. 2 (2021); 56-61 2795-4358 1647-0559 10.34632/cadernosdesaude.2021.13.2 reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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RCAAP |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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