Naslov
Bioethical Aspects of Palliative Care/Medicine

Autori
Brkljačić, Morana

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, stručni

Izvornik
9th World Congress of Bioethics "The Challenge of Cross-Cultural Bioethics in the 21st Century" : Book of Abstracts / - Rijeka : The International Association of Bioethics ; University of Rijeka, School of Medicine ; The Croatian Society for Clinical Bioethics, 2008, 253-254

Skup
World Congress of Bioethics "The Challenge of Cross-Cultural Bioethics in the 21st Century" (9 ; 2008)

Mjesto i datum
Rijeka, Hrvatska, 03.09.2008. - 08.09.2008

Vrsta sudjelovanja
Predavanje

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
bioethics; palliative care/medicine; terminal illness; patient autonomy

Sažetak
The ethical treatment of patients, especially terminal patients in the last phase of their disease, as well as the ethical approach to their illnesses and needs, are a subject of medicine and medical ethics - bioethics. In most European countries and in America, palliative care is today well established as a discreet field of clinical medicine with interdisciplinary clinical teams working in the community, in regional hospice centres, and in the palliative departments of hospitals, alongside their fellow clinicians in oncology and other specialist departments. Let us remember that palliative care is a specific form of medical care for patients in the terminal (final) phase of life. It is an approach to improve the quality of life of patients faced with fatal diseases, and their families. Palliative care starts when classical methods of treatment have been exhausted, or when the symptoms of a malignant disease reach a level that a patient can hardly endure. It encompasses three areas: soothing the symptoms, giving psycho-sociological support to the patients and their caregivers, and dealing with ethical problems concerning the end of life. Particularly important are the ethics of the palliative care, because they focus on aspects of the care aimed at the patient and critical decision-making. The decisions made in this part of the medicine (palliative medicine) differ in nature from those in curative medicine, where more attention is given to radical interventions. The decisions made in palliative medicine require moral, legal and medical judgements. At the same time, one must strike a balance between clinical aspects of the care and the patient's autonomy regarding his wishes, beliefs, and finally decisions about his own medical treatment. Ethical aspects of decision-making cannot be separated from the clinical circumstances of an individual case, in the same way as medical decision-making cannot neglect the four (bio)ethical principles: beneficence, non-maleficence, autonomy of the person, and justice. One of the most controversial (bio)ethical questions with regard to hospice care is the distinction between active euthanasia and the choice to permit the death to occur as a result of the development of the illness without making any interventions. In the context of hospice care, a well-informed patient or a person that makes decisions in his best interest can refuse the treatment and accept a care plan aimed more at giving consolation than prolonging life. When making a decision regarding the treatment at the end of a patient's life, and bearing in mind the patient's autonomy, one must take into account the possibility of abusing the consent, especially if it is a fictive consent on the basis of a letter of authorisation (the so-called "proxy" consent). The point at which ethics are integrated into clinical praxis may not be reached every time, but it is a necessary aim to which modern medical ethics – bioethics – should strive.

Izvorni jezik
Engleski

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