Dying is an event that affects human development throughout the life cycle—impacting individuals, communities, and society. Providing terminal care may mitigate the suffering of patients and families. Notwithstanding, it poses challenges concerning patients’ decision-making and autonomy, in regard to communicating bad news, resuscitation orders, and voluntary termination of life. This study seeks to discuss ethical issues underlying terminal care, showing how the problem of patients’ decision-making and autonomy can be addressed at the end of life. It distinguishes the notion of worthy death, which could ground ethical decisions for health attention across different developmental stages.
References
[1]
Sadock, B.J., Sadock, V. and Ruiz, P. (2017) Compêndio de Psiquiatria: Ciência do Comportamento e Psiquiatria Clínica. Artmed, Porto Alegre.
[2]
President’s Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research (1981) Defining Death: A Report on the Medical, Legal and Ethical Issues in the Determination of Death. Government Printing Office, Washington DC.
[3]
Conselho Federal de Medicina (2017) Resolução no 2.173, de 23 de Novembro de 2017. https://saude.rs.gov.br/upload/arquivos/carga20171205/19140504-resolucao-do-conselho-federal-de-medicina-2173-2017.pdf
[4]
Kübler-Ross, E. (1969) On Death and Dying. Scribner, New York.
[5]
American Psychiatric Association (2014) Manual Diagnóstico e Estatístico de Transtornos Mentais: DSM-5. Artmed, Porto Alegre.
[6]
Papalia, D. and Feldman, R. (2013) Desenvolvimento Humano. 12nd Edition, AMGH, Porto Alegre.
[7]
Speece, M. and Brent, S.B. (1984) Children’s Understanding of Death: A Review of Three Components of a Death Concept. Child Development, 55, 1671-1688. https://doi.org/10.2307/1129915
[8]
Bering, J.M. and Bjorklund, D.F. (2004) The Natural Emergence of Reasoning about the Afterlife as a Developmental Regularity. Developmental Psychology, 40, 217-233. https://doi.org/10.1037/0012-1649.40.2.217
[9]
Blakemore, S. and Choudhury, S. (2006) Development of the Adolescent Brain: Implications for Executive Function and Social Cognition. Journal of Child Psychology and Psychiatry, 47, 296-312. https://doi.org/10.1111/j.1469-7610.2006.01611.x
[10]
Erikson, E. (1978) Adulthood. W. W. Norton & Company, New York.
[11]
Kelley, A. and Meier, D.E. (2010) Palliative Care: A Shifting Paradigm. The New England Journal of Medicine, 363, 781-782. https://doi.org/10.1056/NEJMe1004139
[12]
Conselho Federal de Medicina (2012) Resolução no 1.995, de 9 de Agosto de 2012. http://www.portalmedico.org.br/resolucoes/cfm/2012/1995_2012.pdf
[13]
American Psychiatric Association (2016) Position Statement on Medical Euthanasia. https://psychiatry.org/File%20Library/About-APA/Organization-Documents-Policies/Policies/Position-2016-Medical-Euthanasia.pdf
[14]
American Medical Association (2018) Code of Medical Ethics: Caring for Patients at the End of Life. https://www.ama-assn.org/delivering-care/ethics/code-medical-ethics-caring-patients-end-life
[15]
British Medical Association (2012) Medical Ethics Today: The BMA’s Handbook of Ethics and Law. John Wiley & Sons, London. https://doi.org/10.1002/9781444355666
[16]
Savulescu, J. and Schuklenk, U. (2017) Doctors Have no Right to Refuse Medical Assistance in Dying, Abortion or Contraception. Bioethics, 31, 162-170. https://doi.org/10.1111/bioe.12288
[17]
Brasil (1940) Decreto-Lei no 2.848, de 7 de Dezembro de 1940. http://www.planalto.gov.br/ccivil_03/decreto-lei/del2848compilado.htm
[18]
Hermsem, M. and Have, T. (2005) Decision-Making in Palliative Care Practice and the Need for Moral Deliberation: A Qualitative Study. Patient Education and Counseling, 56, 268-275. https://doi.org/10.1016/j.pec.2004.03.013
