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Problemas y decisiones al final de la vida en pacientes con enfermedad en etapa terminal.

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Title: Problemas y decisiones al final de la vida en pacientes con enfermedad en etapa terminal.
Alternate Title: Terminally-ill patients' end of life problems and related decisions.
Authors: Sarmiento-Medina, María I.1 sarmientomaria@unbosque.edu.co, Vargas-Cruz, Sandra L.1 vargassandra@unbosque.edu.co, Velásquez-Jiménez, Claudia M.2 cmvelasquez@unisanitas.edu.co, de Jaramillo, Margarita Sierra1 sierramargarita@unbosque.edu.co
Source: Revista de Salud Pública. jan/feb2012, Vol. 14 Issue 1, p116-128. 13p.
Subjects: TERMINALLY ill, DEATH, MEDICAL decision making, EUTHANASIA, PAIN management, DEGENERATION (Pathology), PATIENTS' rights
Abstract (English): Objectives Describing terminally-ill patients and their relatives' preferences regarding end of life decisions, the underlying problems and reasons leading to them requesting support. Methods This was a descriptive, exploratory analysis of the secondary sources in an NGO providing support for patients at the end of their lives. Results The most frequent choice was dying with dignity (43 %), followed by euthanasia (12 %). Some people asked for guidance on legal and ethical aspects regarding appropriate care for the terminally-ill. The pathologies accounting for 75 % of the diagnoses were chronic degenerative diseases, cancer and coma. The worsening of symptoms was the main reason for requesting support and uncontrollable pain more often led to the choice of euthanasia. Only 14 % of the patients had formalised their wills regarding their end of life decisions. The choice of dying with dignity was related to rejecting futile measures and therapeutic cruelty. Euthanasia was seen as an autonomous intentional action to end suffering. The family plays an essential role in making end of life decisions. Conclusions End of life decisions are motivated by a perception of undignified conditions for patients due to progressive deterioration, poorly controlled pain, abandoning of chronic patients, therapeutic obstinacy and unnecessary measures that postpone death. They are taken within a complex context concerning religious dilemmas and ethical or legal concerns. [ABSTRACT FROM AUTHOR]
Abstract (Spanish): Objetivos Describir preferencias en las decisiones al final de la vida en pacientes y familiares, problemas que subyacen y motivos que los llevan a solicitar apoyo. Métodos Estudio descriptivo, exploratorio de fuentes secundarias de una ONG que brinda apoyo a los pacientes al final de la vida. Resultados La opción más frecuente fue la muerte digna en 43 % seguida de la eutanasia en un 12 %. Un 22 % de las personas solicitaban orientación sobre aspectos éticos y legales y además referentes a la atención adecuada para enfermos terminales. Las patologías que ocuparon el 75 % de los diagnósticos fueron Enfermedad Crónica Degenerativa, Cáncer y Estado de Coma. La agudización de síntomas fue el principal motivo por el cual solicitaron apoyo y el dolor incontrolable llevó con más frecuencia a la opción por la eutanasia. Sólo 14 % de los pacientes habían formalizado sus voluntades anticipadas respecto al final de la vida. La opción de muerte digna se relacionó con el rechazo a medidas fútiles y al encarnizamiento terapéutico. La eutanasia se percibió como acción intencional y autónoma de poner fin al sufrimiento. La familia juega un papel esencial en la toma de decisiones. Conclusiones Las decisiones al final de la vida son motivadas por la percepción de unas condiciones no dignas debidas al deterioro progresivo, dolor mal controlado, abandono del paciente crónico, encarnizamiento terapéutico y uso de medidas innecesarias que posponen la muerte. Se toman en un contexto complejo de dilemas religiosos, éticos y legales. [ABSTRACT FROM AUTHOR]
Copyright of Revista de Salud Pública is the property of Universidad Nacional de Colombia and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: MedicLatina
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  Data: Problemas y decisiones al final de la vida en pacientes con enfermedad en etapa terminal.
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  Data: Terminally-ill patients' end of life problems and related decisions.
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  Data: <searchLink fieldCode="AR" term="%22Sarmiento-Medina%2C+María+I%2E%22">Sarmiento-Medina, María I.</searchLink><relatesTo>1</relatesTo><i> sarmientomaria@unbosque.edu.co</i><br /><searchLink fieldCode="AR" term="%22Vargas-Cruz%2C+Sandra+L%2E%22">Vargas-Cruz, Sandra L.</searchLink><relatesTo>1</relatesTo><i> vargassandra@unbosque.edu.co</i><br /><searchLink fieldCode="AR" term="%22Velásquez-Jiménez%2C+Claudia+M%2E%22">Velásquez-Jiménez, Claudia M.</searchLink><relatesTo>2</relatesTo><i> cmvelasquez@unisanitas.edu.co</i><br /><searchLink fieldCode="AR" term="%22de+Jaramillo%2C+Margarita+Sierra%22">de Jaramillo, Margarita Sierra</searchLink><relatesTo>1</relatesTo><i> sierramargarita@unbosque.edu.co</i>
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  Data: <searchLink fieldCode="JN" term="%22Revista+de+Salud+Pública%22">Revista de Salud Pública</searchLink>. jan/feb2012, Vol. 14 Issue 1, p116-128. 13p.
– Name: Subject
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  Data: <searchLink fieldCode="DE" term="%22TERMINALLY+ill%22">TERMINALLY ill</searchLink><br /><searchLink fieldCode="DE" term="%22DEATH%22">DEATH</searchLink><br /><searchLink fieldCode="DE" term="%22MEDICAL+decision+making%22">MEDICAL decision making</searchLink><br /><searchLink fieldCode="DE" term="%22EUTHANASIA%22">EUTHANASIA</searchLink><br /><searchLink fieldCode="DE" term="%22PAIN+management%22">PAIN management</searchLink><br /><searchLink fieldCode="DE" term="%22DEGENERATION+%28Pathology%29%22">DEGENERATION (Pathology)</searchLink><br /><searchLink fieldCode="DE" term="%22PATIENTS'+rights%22">PATIENTS' rights</searchLink>
– Name: Abstract
  Label: Abstract (English)
  Group: Ab
  Data: Objectives Describing terminally-ill patients and their relatives' preferences regarding end of life decisions, the underlying problems and reasons leading to them requesting support. Methods This was a descriptive, exploratory analysis of the secondary sources in an NGO providing support for patients at the end of their lives. Results The most frequent choice was dying with dignity (43 %), followed by euthanasia (12 %). Some people asked for guidance on legal and ethical aspects regarding appropriate care for the terminally-ill. The pathologies accounting for 75 % of the diagnoses were chronic degenerative diseases, cancer and coma. The worsening of symptoms was the main reason for requesting support and uncontrollable pain more often led to the choice of euthanasia. Only 14 % of the patients had formalised their wills regarding their end of life decisions. The choice of dying with dignity was related to rejecting futile measures and therapeutic cruelty. Euthanasia was seen as an autonomous intentional action to end suffering. The family plays an essential role in making end of life decisions. Conclusions End of life decisions are motivated by a perception of undignified conditions for patients due to progressive deterioration, poorly controlled pain, abandoning of chronic patients, therapeutic obstinacy and unnecessary measures that postpone death. They are taken within a complex context concerning religious dilemmas and ethical or legal concerns. [ABSTRACT FROM AUTHOR]
– Name: Abstract
  Label: Abstract (Spanish)
  Group: Ab
  Data: Objetivos Describir preferencias en las decisiones al final de la vida en pacientes y familiares, problemas que subyacen y motivos que los llevan a solicitar apoyo. Métodos Estudio descriptivo, exploratorio de fuentes secundarias de una ONG que brinda apoyo a los pacientes al final de la vida. Resultados La opción más frecuente fue la muerte digna en 43 % seguida de la eutanasia en un 12 %. Un 22 % de las personas solicitaban orientación sobre aspectos éticos y legales y además referentes a la atención adecuada para enfermos terminales. Las patologías que ocuparon el 75 % de los diagnósticos fueron Enfermedad Crónica Degenerativa, Cáncer y Estado de Coma. La agudización de síntomas fue el principal motivo por el cual solicitaron apoyo y el dolor incontrolable llevó con más frecuencia a la opción por la eutanasia. Sólo 14 % de los pacientes habían formalizado sus voluntades anticipadas respecto al final de la vida. La opción de muerte digna se relacionó con el rechazo a medidas fútiles y al encarnizamiento terapéutico. La eutanasia se percibió como acción intencional y autónoma de poner fin al sufrimiento. La familia juega un papel esencial en la toma de decisiones. Conclusiones Las decisiones al final de la vida son motivadas por la percepción de unas condiciones no dignas debidas al deterioro progresivo, dolor mal controlado, abandono del paciente crónico, encarnizamiento terapéutico y uso de medidas innecesarias que posponen la muerte. Se toman en un contexto complejo de dilemas religiosos, éticos y legales. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
  Group: Ab
  Data: <i>Copyright of Revista de Salud Pública is the property of Universidad Nacional de Colombia and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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      – Type: doi
        Value: 10.1590/S0124-00642012000100010
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      – Code: spa
        Text: Spanish
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      – SubjectFull: TERMINALLY ill
        Type: general
      – SubjectFull: DEATH
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      – SubjectFull: MEDICAL decision making
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      – SubjectFull: EUTHANASIA
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      – SubjectFull: PAIN management
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      – SubjectFull: DEGENERATION (Pathology)
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      – SubjectFull: PATIENTS' rights
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