Abstract

SARMIENTO-MEDINA, María I; VARGAS-CRUZ, Sandra L; VELASQUEZ-JIMENEZ, Claudia M  and  SIERRA DE JARAMILLO, Margarita. Terminally-ill patients' end of life problems and related decisions. Rev. salud pública [online]. 2012, vol.14, n.1, pp.116-128. ISSN 0124-0064.

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.

Keywords : Terminally ill; decision-making; pain; right to die; euthanasia; patient's rights.

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