“When no one understands each other”: bioethical conflicts in a real case at the end of life
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.2021.9564 |
Resumo: | Introduction: The technical-scientific evolution of the last decades is reflected in the extension of life expectancy, in the reduction of the mortality rate due to infectious diseases and in the increase in mortality due to chronic-degenerative diseases. Added to this is the formation of medical education, increasingly equipped with a model oriented towards the use of highly sophisticated technologies, seeming to neglect the traditional field of the doctor-patient relationship. When the ultimate goal is the cure, death is considered a failure, an unacceptable result. Despite all the effort and technology used, death remains an inevitable outcome. The sick person, when in the background, ceases to be the protagonist of his story. Bioethics is a branch of knowledge that aims to indicate the limits and purposes of man's intervention in life, based on recognition for the dignity of the Human Person. “What should i do against what can I do?” End-of-life care commonly involves ethical issues that lead health professionals, patients and family members to face dilemmas, conflicts. Aim: This paper’s purpose is to show how challenging the decision-making process can be for those involved, namely health professionals, family members and users. Materials and methods: Facing a real case, ethical principles are presented and developed respecting the perspective of bioethics. Results: Starting with the conceptions of dignity, as well as possible weaknesses, covering more technical aspects such as the adequacy of therapeutic effort and proportionality of interventions, contemplating the concepts of obstinacy and therapeutic futility, exploring the dimension of autonomy (including some of its legal aspects) and ending in the field of justice and equity. Having these in hands, it becomes clear the complexity that the decision-making process gains when the humane and multidimensional aspect of the person who suffers, the patient (and family and their loved ones), is called into question. Conclusion: The considerations listed by the bioethical principles help us to base our professional actions, in order to, assist and consider, the environment and principles of the patient, the patient’s family and closed ones along with ours, as an assistance team. Resulting in the neglection of simple and absolute certainties, the lessening of doubts regarding this process and the election of the best possible answer for that specific patient, team and the context that surrounds them. Similarly, on this particular end of life situation, the concept of palliative care is highlighted as a tool of similar impact. |
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“When no one understands each other”: bioethical conflicts in a real case at the end of life“Quando ninguém se entende”: conflitos bioéticos num caso real de fim de vidaIntroduction: The technical-scientific evolution of the last decades is reflected in the extension of life expectancy, in the reduction of the mortality rate due to infectious diseases and in the increase in mortality due to chronic-degenerative diseases. Added to this is the formation of medical education, increasingly equipped with a model oriented towards the use of highly sophisticated technologies, seeming to neglect the traditional field of the doctor-patient relationship. When the ultimate goal is the cure, death is considered a failure, an unacceptable result. Despite all the effort and technology used, death remains an inevitable outcome. The sick person, when in the background, ceases to be the protagonist of his story. Bioethics is a branch of knowledge that aims to indicate the limits and purposes of man's intervention in life, based on recognition for the dignity of the Human Person. “What should i do against what can I do?” End-of-life care commonly involves ethical issues that lead health professionals, patients and family members to face dilemmas, conflicts. Aim: This paper’s purpose is to show how challenging the decision-making process can be for those involved, namely health professionals, family members and users. Materials and methods: Facing a real case, ethical principles are presented and developed respecting the perspective of bioethics. Results: Starting with the conceptions of dignity, as well as possible weaknesses, covering more technical aspects such as the adequacy of therapeutic effort and proportionality of interventions, contemplating the concepts of obstinacy and therapeutic futility, exploring the dimension of autonomy (including some of its legal aspects) and ending in the field of justice and equity. Having these in hands, it becomes clear the complexity that the decision-making process gains when the humane and multidimensional aspect of the person who suffers, the patient (and family and their loved ones), is called into question. Conclusion: The considerations listed by the bioethical principles help us to base our professional actions, in order to, assist and consider, the environment and principles of the patient, the patient’s family and closed ones along with ours, as an assistance team. Resulting in the neglection of simple and absolute certainties, the lessening of doubts regarding this process and the election of the best possible answer for that specific patient, team and the context that surrounds them. Similarly, on this particular end of life situation, the concept of palliative care is highlighted as a tool of similar impact.Introdução: A evolução técnico-científica das últimas décadas traduz-se no alargamento da expectativa de vida, na diminuição da taxa de mortalidade por doenças infectocontagiosas e no aumento da mortalidade devido às doenças crônico-degenerativas. Soma-se a isso a formação da educação médica, dotada cada vez mais de um modelo orientado para o uso de tecnologias altamente sofisticadas, parecendo negligenciar o tradicional campo da relação médico-utente. Quando o objetivo final é a cura, a morte passa a ser considerada um fracasso, um resultado inaceitável. Apesar de todo o esforço e tecnologia usada, a morte continua sendo um desfecho inevitável. A pessoa doente, quando em segundo plano, deixa de ser o protagonista da sua história. A bioética é um ramo do conhecimento que visa indicar os limites e as finalidades da intervenção do homem sobre a vida, tendo como fundamento o reconhecimento pela dignidade da Pessoa Humana. “o que devo fazer frente ao que posso fazer?” Os cuidados de fim de vida comumente envolvem questões éticas que levam os profissionais de saúde, pacientes e familiares a enfrentarem dilemas, conflitos. Objetivo: O presente trabalho propõe mostrar o quanto pode ser desafiador o processo de tomada de decisão para os envolvidos, nomeadamente os profissionais de saúde, familiares e utentes. Materiais e métodos: Diante de um caso real, os princípios éticos são apresentados e desenvolvidos respeitando a ótica da bioética. Resultados: A começar pelas concepções de dignidade, assim como suas possíveis fragilidades, perpassando aspectos mais técnicos como a adequação de esforço terapêutico e proporcionalidade de intervenções, contemplando os conceitos de obstinação e futilidade terapêutica, explorando a dimensão da autonomia (inclusive alguns de seus aspectos legais) e encerrando no campo da justiça e equidade, faz-se clara a complexidade que o processo de tomada de decisões ganha quando o aspecto humano e multifacetado da pessoa que sofre, o utente (e família), é posto em causa. Conclusão: As ponderações elencadas pelos princípios bioéticos auxiliam-nos a fundamentar o nosso agir profissional, de forma a considerar o mundo do utente, de seus familiares e/ou pessoas próximas e o nosso enquanto equipa assistencial. Como resultado, é suposto o abandono de certezas dogmáticas e simplistas, o abrandamento das incertezas inerentes ao processo e a eleição de uma melhor resposta possível: individualizada para aquele utente, por aquela equipa, naquele contexto. Aproximando-se do caso em questão, nas situações de fim de vida, a filosofia dos cuidados paliativos destaca-se como ferramenta de semelhante impacto.Universidade Católica Portuguesa2021-01-04info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttps://doi.org/10.34632/cadernosdesaude.2021.9564https://doi.org/10.34632/cadernosdesaude.2021.9564Cadernos de Saúde; Vol 13 No 1 (2021); 4-11Cadernos de Saúde; v. 13 n. 1 (2021); 4-112795-43581647-055910.34632/cadernosdesaude.2021.13.1reponame: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/9564https://revistas.ucp.pt/index.php/cadernosdesaude/article/view/9564/9913Direitos de Autor (c) 2021 Ricardo Lucas de Souza Rodrigues, Marta Alexandra de Almeida Magnos, Sofia Marques Inglês Gomes Covas, Valéria Guedes Ferreira da Silva Castro, Valquiria Cardoso Alves Chagashttp://creativecommons.org/licenses/by/4.0info:eu-repo/semantics/openAccessRodrigues, Ricardo Lucas de SouzaMagnos, Marta Alexandra de AlmeidaCovas, Sofia Marques Inglês GomesCastro, Valéria Guedes Ferreira da SilvaChagas, Valquiria Cardoso Alves2023-10-03T15:47:58Zoai:ojs.revistas.ucp.pt:article/9564Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T20:33:10.012199Repositório 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 |
“When no one understands each other”: bioethical conflicts in a real case at the end of life “Quando ninguém se entende”: conflitos bioéticos num caso real de fim de vida |
title |
“When no one understands each other”: bioethical conflicts in a real case at the end of life |
spellingShingle |
“When no one understands each other”: bioethical conflicts in a real case at the end of life Rodrigues, Ricardo Lucas de Souza |
title_short |
“When no one understands each other”: bioethical conflicts in a real case at the end of life |
title_full |
“When no one understands each other”: bioethical conflicts in a real case at the end of life |
title_fullStr |
“When no one understands each other”: bioethical conflicts in a real case at the end of life |
title_full_unstemmed |
“When no one understands each other”: bioethical conflicts in a real case at the end of life |
title_sort |
“When no one understands each other”: bioethical conflicts in a real case at the end of life |
author |
Rodrigues, Ricardo Lucas de Souza |
author_facet |
Rodrigues, Ricardo Lucas de Souza Magnos, Marta Alexandra de Almeida Covas, Sofia Marques Inglês Gomes Castro, Valéria Guedes Ferreira da Silva Chagas, Valquiria Cardoso Alves |
author_role |
author |
author2 |
Magnos, Marta Alexandra de Almeida Covas, Sofia Marques Inglês Gomes Castro, Valéria Guedes Ferreira da Silva Chagas, Valquiria Cardoso Alves |
author2_role |
author author author author |
dc.contributor.author.fl_str_mv |
Rodrigues, Ricardo Lucas de Souza Magnos, Marta Alexandra de Almeida Covas, Sofia Marques Inglês Gomes Castro, Valéria Guedes Ferreira da Silva Chagas, Valquiria Cardoso Alves |
description |
Introduction: The technical-scientific evolution of the last decades is reflected in the extension of life expectancy, in the reduction of the mortality rate due to infectious diseases and in the increase in mortality due to chronic-degenerative diseases. Added to this is the formation of medical education, increasingly equipped with a model oriented towards the use of highly sophisticated technologies, seeming to neglect the traditional field of the doctor-patient relationship. When the ultimate goal is the cure, death is considered a failure, an unacceptable result. Despite all the effort and technology used, death remains an inevitable outcome. The sick person, when in the background, ceases to be the protagonist of his story. Bioethics is a branch of knowledge that aims to indicate the limits and purposes of man's intervention in life, based on recognition for the dignity of the Human Person. “What should i do against what can I do?” End-of-life care commonly involves ethical issues that lead health professionals, patients and family members to face dilemmas, conflicts. Aim: This paper’s purpose is to show how challenging the decision-making process can be for those involved, namely health professionals, family members and users. Materials and methods: Facing a real case, ethical principles are presented and developed respecting the perspective of bioethics. Results: Starting with the conceptions of dignity, as well as possible weaknesses, covering more technical aspects such as the adequacy of therapeutic effort and proportionality of interventions, contemplating the concepts of obstinacy and therapeutic futility, exploring the dimension of autonomy (including some of its legal aspects) and ending in the field of justice and equity. Having these in hands, it becomes clear the complexity that the decision-making process gains when the humane and multidimensional aspect of the person who suffers, the patient (and family and their loved ones), is called into question. Conclusion: The considerations listed by the bioethical principles help us to base our professional actions, in order to, assist and consider, the environment and principles of the patient, the patient’s family and closed ones along with ours, as an assistance team. Resulting in the neglection of simple and absolute certainties, the lessening of doubts regarding this process and the election of the best possible answer for that specific patient, team and the context that surrounds them. Similarly, on this particular end of life situation, the concept of palliative care is highlighted as a tool of similar impact. |
publishDate |
2021 |
dc.date.none.fl_str_mv |
2021-01-04 |
dc.type.status.fl_str_mv |
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.2021.9564 https://doi.org/10.34632/cadernosdesaude.2021.9564 |
url |
https://doi.org/10.34632/cadernosdesaude.2021.9564 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.relation.none.fl_str_mv |
https://revistas.ucp.pt/index.php/cadernosdesaude/article/view/9564 https://revistas.ucp.pt/index.php/cadernosdesaude/article/view/9564/9913 |
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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 |
dc.source.none.fl_str_mv |
Cadernos de Saúde; Vol 13 No 1 (2021); 4-11 Cadernos de Saúde; v. 13 n. 1 (2021); 4-11 2795-4358 1647-0559 10.34632/cadernosdesaude.2021.13.1 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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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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