Soins palliatifs et médecine

Abstrait

End-of-Life Decision Making in the Context of Chronic Life-Limiting Disease

Sarah King

Variability in practice, insufficient predictive models for death, elusive knowledge of patient preferences, poor communication between staff and surrogates, insufficient or absent training of health-care providers, the use of imprecise and insensitive terminology, and incomplete documentation in medical records were among the issues identified by the jurors. The research towards improving end-of-life care is performed. The verdict recommends a "shared" approach to end-of-life decision-making that includes caregivers and patient surrogates. Respect for the autonomy of the patient, as well as the desire to honor the patient's decision to refuse undesirable therapies, should be communicated to the family. The negotiating process will decide the conclusion, which will be influenced by the personalities and beliefs of the players. In the end, it is the Variability in practice, insufficient predictive models for death, elusive knowledge of patient preferences, poor communication between staff and surrogates, insufficient or absent training of health-care providers, the use of imprecise and insensitive terminology, and incomplete documentation in medical records were among the issues identified by the jurors. The research towards improving end-of-life care is performed. The verdict recommends a "shared" approach to end-of-life decision-making that includes caregivers and patient surrogates. The sufferer must be guaranteed a painless death. The Consensus Conference jury agrees with the moral and legal grounds prohibiting the administration of therapies intended to hasten death. The patient must be provided enough analgesia to relieve pain and anguish; if this analgesia hastens death, the "double impact" should not detract from the primary goal of providing comfort