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Terminalidade da vida em terapia intensiva: posicionamento dos familiares sobre ortotanásia

DOI: 10.1590/S0103-507X2011000400009

Keywords: family, critical illness, intensive care, attitude to death, ethics, communication.

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Abstract:

objectives: this study aimed to assess family member acceptance of orthotanasia as related to symptom management, patient preference and the influence of the medical team's communication on therapy. methods: this was a descriptive one-year study conducted at the adult intensive care unit of the hospital do servidor público estadual. a structured questionnaire based on the quality of dying and death (qodd 22) instrument and prior informal interviews were used. results: sixty family members were assessed; the mean age was 51.7 + 12.1 years, and 81.7% were female. the patients were hospitalized for a mean of 31 + 26.9 days, and 17.0% of these days were spent in the intensive care unit. most of the patients had neurological conditions. most of the patients (53.3%) had discussed their end-of-life care wishes with family members; however, 76.7% of them had not discussed this issue with their doctors (p < 0.00). the family members reported being favorable to orthotanasia in 83.3% of the cases. most (85.0%) desired the medical team to clearly approach the subject, and 65.0% wished to take part in the quality of end-of-life decision making process. the family members were generally satisfied with information they received from the doctors: 93.3% believed they had received appropriately frequent communications about the clinical conditions; 81.7% were able to clarify their doubts regarding the patient's clinical status; the communication was understood by 83.3% of the respondents; and 80.0% believed that clear and honest information had been provided. only 43.3% of the respondents wished to be present at the time of their loved ones' deaths. a significant association between family member acceptance of orthotanasia and participation in end-of-life decisions (p = 0.042) was observed. conclusions: most of the respondents were favorable to orthotanasia and wished to participate in end-of-life discussions.

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