Palliative sedation: bioethical analysis of a real end-of-life case
Autor(a) principal: | |
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Data de Publicação: | 2023 |
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.2023.11722 |
Resumo: | Introduction: Ethically conscious Palliative Care represents complex challenges, particularly with regard to the management of refractory symptoms such as pain. Palliative sedation has been subject of intense debate, as it involves ethically controversial issues, leading health professionals, patients, and family members to be confronted with conflicts regarding its initiation. Objectives: To promote a bioethical reflexion on the institution of palliative sedation in patients actively dying. Material and methods: Based on a clinical case, we intend to develop a bioethical analysis of the topic of palliative sedation initiation and its complexity, based on the literature and ethical principles. Results: Ethical reflections on palliative sedation have been based on the principles of double effect, proportionality, and autonomy. These highlight the intentionality of the medical act and the existence of proportional reasons in the choice of palliative sedation, considering the patient’s autonomous decision. The principles on beneficence and non-maleficence define that the initiation of palliative sedation should be a beneficial act for the patient with the least negative impact possible. The health care provided must be fair and appropriate to the person and their clinical situation. Conclusions: Given the deontological conduct, palliative sedation is an ethically permissible therapy, which has nothing to do with medically assisted suicide or euthanasia. The decision-making process of its institution must occur as a result of a multidisciplinary teamwork, based on the will and/or the consent of the person that is actively dying. A compreensive approach to the patient is necessary, and the intervention of a team specialized in Palliative Care essential. |
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Palliative sedation: bioethical analysis of a real end-of-life caseSedação paliativa: análise bioética de um caso real em final de vidaIntroduction: Ethically conscious Palliative Care represents complex challenges, particularly with regard to the management of refractory symptoms such as pain. Palliative sedation has been subject of intense debate, as it involves ethically controversial issues, leading health professionals, patients, and family members to be confronted with conflicts regarding its initiation. Objectives: To promote a bioethical reflexion on the institution of palliative sedation in patients actively dying. Material and methods: Based on a clinical case, we intend to develop a bioethical analysis of the topic of palliative sedation initiation and its complexity, based on the literature and ethical principles. Results: Ethical reflections on palliative sedation have been based on the principles of double effect, proportionality, and autonomy. These highlight the intentionality of the medical act and the existence of proportional reasons in the choice of palliative sedation, considering the patient’s autonomous decision. The principles on beneficence and non-maleficence define that the initiation of palliative sedation should be a beneficial act for the patient with the least negative impact possible. The health care provided must be fair and appropriate to the person and their clinical situation. Conclusions: Given the deontological conduct, palliative sedation is an ethically permissible therapy, which has nothing to do with medically assisted suicide or euthanasia. The decision-making process of its institution must occur as a result of a multidisciplinary teamwork, based on the will and/or the consent of the person that is actively dying. A compreensive approach to the patient is necessary, and the intervention of a team specialized in Palliative Care essential.Introdução: Cuidados Paliativos eticamente conscientes representam desafios complexos, nomeadamente no que concerne à abordagem de sintomas refratários como a dor. A sedação paliativa tem sido objeto de intenso debate, já que envolve questões eticamente controversas, levando os profissionais de saúde, doentes e familiares a confrontarem-se com conflitos relativamente à sua iniciação. Objetivos: Promover uma reflexão bioética sobre a instituição de sedação paliativa em doentes em final de vida. Materiais e métodos: Tendo por base um caso clínico, pretende-se desenvolver uma análise bioética do tema da iniciação de sedação paliativa e sua complexidade, tendo por base a literatura e princípios éticos. Resultados: As reflexões éticas sobre sedação paliativa têm sido baseadas nos princípios do duplo efeito, proporcionalidade e autonomia. Estes salientam a intencionalidade do ato médico e a existência de razões proporcionais na escolha de sedação paliativa, considerando a decisão autónoma da doente. Os princípios da beneficência e não maleficência definem que a iniciação de sedação paliativa deve ser um ato benéfico para a doente e do qual resulte o menor dano possível. Os cuidados de saúde proporcionados devem ser justos e adequados à pessoa e sua situação clínica. Conclusões: Atendendo à conduta deontológica, a sedação paliativa é uma terapêutica eticamente permissível, que em nada se relaciona com suicídio medicamente assistido ou eutanásia. O processo de tomada de decisão sobre a sua instituição deve ocorrer como resultado do trabalho de equipa multidisciplinar, a partir da vontade e/ou consentimento da pessoa em fim de vida. A abordagem integral do doente é necessária, e a intervenção por uma equipa especializada em Cuidados Paliativos fundamental.Universidade Católica Portuguesa2023-06-01info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttps://doi.org/10.34632/cadernosdesaude.2023.11722https://doi.org/10.34632/cadernosdesaude.2023.11722Cadernos de Saúde; Vol 15 No 1 (2023); 51-55Cadernos de Saúde; v. 15 n. 1 (2023); 51-552795-43581647-055910.34632/cadernosdesaude.2023.15.1reponame: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/11722https://revistas.ucp.pt/index.php/cadernosdesaude/article/view/11722/12372Direitos de Autor (c) 2023 Maria Isabel Bessa Cruz de Sá e Lucas, Ana Rita Simões Rodrigues Marques, Inês Filipa de Matos Santos, Margarida Isabel dos Santos Costa Silva, Patrícia Alexandra Nunes de Oliveira Sardinhahttp://creativecommons.org/licenses/by/4.0info:eu-repo/semantics/openAccessLucas, Maria Isabel Bessa Cruz de Sá eMarques, Ana Rita Simões RodriguesSantos, Inês Filipa de MatosSilva, Margarida Isabel dos Santos CostaSardinha, Patrícia Alexandra Nunes de Oliveira2023-10-03T15:48:10Zoai:ojs.revistas.ucp.pt:article/11722Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T20:33:14.128291Repositório 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 |
Palliative sedation: bioethical analysis of a real end-of-life case Sedação paliativa: análise bioética de um caso real em final de vida |
title |
Palliative sedation: bioethical analysis of a real end-of-life case |
spellingShingle |
Palliative sedation: bioethical analysis of a real end-of-life case Lucas, Maria Isabel Bessa Cruz de Sá e |
title_short |
Palliative sedation: bioethical analysis of a real end-of-life case |
title_full |
Palliative sedation: bioethical analysis of a real end-of-life case |
title_fullStr |
Palliative sedation: bioethical analysis of a real end-of-life case |
title_full_unstemmed |
Palliative sedation: bioethical analysis of a real end-of-life case |
title_sort |
Palliative sedation: bioethical analysis of a real end-of-life case |
author |
Lucas, Maria Isabel Bessa Cruz de Sá e |
author_facet |
Lucas, Maria Isabel Bessa Cruz de Sá e Marques, Ana Rita Simões Rodrigues Santos, Inês Filipa de Matos Silva, Margarida Isabel dos Santos Costa Sardinha, Patrícia Alexandra Nunes de Oliveira |
author_role |
author |
author2 |
Marques, Ana Rita Simões Rodrigues Santos, Inês Filipa de Matos Silva, Margarida Isabel dos Santos Costa Sardinha, Patrícia Alexandra Nunes de Oliveira |
author2_role |
author author author author |
dc.contributor.author.fl_str_mv |
Lucas, Maria Isabel Bessa Cruz de Sá e Marques, Ana Rita Simões Rodrigues Santos, Inês Filipa de Matos Silva, Margarida Isabel dos Santos Costa Sardinha, Patrícia Alexandra Nunes de Oliveira |
description |
Introduction: Ethically conscious Palliative Care represents complex challenges, particularly with regard to the management of refractory symptoms such as pain. Palliative sedation has been subject of intense debate, as it involves ethically controversial issues, leading health professionals, patients, and family members to be confronted with conflicts regarding its initiation. Objectives: To promote a bioethical reflexion on the institution of palliative sedation in patients actively dying. Material and methods: Based on a clinical case, we intend to develop a bioethical analysis of the topic of palliative sedation initiation and its complexity, based on the literature and ethical principles. Results: Ethical reflections on palliative sedation have been based on the principles of double effect, proportionality, and autonomy. These highlight the intentionality of the medical act and the existence of proportional reasons in the choice of palliative sedation, considering the patient’s autonomous decision. The principles on beneficence and non-maleficence define that the initiation of palliative sedation should be a beneficial act for the patient with the least negative impact possible. The health care provided must be fair and appropriate to the person and their clinical situation. Conclusions: Given the deontological conduct, palliative sedation is an ethically permissible therapy, which has nothing to do with medically assisted suicide or euthanasia. The decision-making process of its institution must occur as a result of a multidisciplinary teamwork, based on the will and/or the consent of the person that is actively dying. A compreensive approach to the patient is necessary, and the intervention of a team specialized in Palliative Care essential. |
publishDate |
2023 |
dc.date.none.fl_str_mv |
2023-06-01 |
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info:eu-repo/semantics/publishedVersion |
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info:eu-repo/semantics/article |
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article |
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publishedVersion |
dc.identifier.uri.fl_str_mv |
https://doi.org/10.34632/cadernosdesaude.2023.11722 https://doi.org/10.34632/cadernosdesaude.2023.11722 |
url |
https://doi.org/10.34632/cadernosdesaude.2023.11722 |
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por |
language |
por |
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https://revistas.ucp.pt/index.php/cadernosdesaude/article/view/11722 https://revistas.ucp.pt/index.php/cadernosdesaude/article/view/11722/12372 |
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http://creativecommons.org/licenses/by/4.0 info:eu-repo/semantics/openAccess |
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http://creativecommons.org/licenses/by/4.0 |
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openAccess |
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Universidade Católica Portuguesa |
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Universidade Católica Portuguesa |
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Cadernos de Saúde; Vol 15 No 1 (2023); 51-55 Cadernos de Saúde; v. 15 n. 1 (2023); 51-55 2795-4358 1647-0559 10.34632/cadernosdesaude.2023.15.1 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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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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