Cuidados paliativos e bioética: estudo com enfermeiros assistenciais Palliative care and bioethics: study with assistance nurses

Abstract

Objective: The objective was to investigate the ethical observances used by nurses assisting the patient without possibilities of cure. Methods: Exploratory research, qualitative in nature, performed with 28 nurses of a public hospital, located in the city of João Pessoa/PB. The data were collected through a questionnaire, from August to October 2012 and subjected to content analysis technique. Results: The categories identified were: Palliative Care: principles of Bioethics to the patient without possibilities of cure and privacy and professional secrecy under the palliative care. Such categories indicated that the professionals are valuing the principles of Bioethics, as well as the privacy and the professional secrecy, using them as a strategy to assist the care to the patient without possibilities of cure. Conclusion: This study is expected to subsidize new investigations, because they are still incipient the research addressing bioethics in patient assistance in palliative care. Bioética, así como la privacidad y el secreto profesional, usándolos como una estrategia para auxiliar a la atención de los pacientes sin posibilidad de cura. Conclusión: Se espera que este estudio pueda subsidiar nuevas investigaciones, pues aún son incipientes las encuestas que abordan la Bioética en la asistencia al paciente bajo Cuidados Paliativos.

Conflitos bioéticos nos cuidados de fim de vida

“…When trying to ease the suffering of terminal patients, healthcare professionals may become more involved than expected. Some studies stress the need for caution in how to proceed in this context to avoid exacerbation and compassion fatigue 8 . Depending on the individual, prognosis and life expectancy, hope is desirable, being the driving force in the struggle for life when there is still possibility of cure.…”

“…Alternatively, some studies [8][9][10]15 suggest educational work and clarification about patients' autonomy to support decision making. However, one must avoid shifting the focus of individual decision making to a supposed collectivity, sharing responsibilities or merely playing the role of "executor" of the will of patients with terminal illness 9,15 .…”

“…Only two publications were found on the subject involving nursing staff 8,17 . Therefore, one may conclude that there is a shortage of studies on the participation of nurses and how they deal with bioethical dilemmas in their relationships with the patients' relatives.…”

Aspectos bioéticos dos cuidados em saúde às pessoas idosas ao fim da vida [Bioethical aspects of the health care provided to older adults at the end of their lives] [Aspectos bioéticos de los cuidados de salud a adultos mayores en el final de la vida]

“…Esta última envolve a prestação de cuidados em saúde no fim da vida. Incluem-se desta forma cuidados adequados para o alívio da dor e dos sintomas decorrentes da fase avançada de uma doença, devendo proporcionar suporte psicossocial e espiritual em todos os estágios, desde o diagnóstico de uma doença incurável até o período de luto da família 5 . A prestação de cuidados ao idoso, portanto, inclui não só a atenção à sua saúde, mas também o envolvimento da família, visto que essa frequentemente exerce a função de cuidadora 6 .…”

“…Sendo assim, os cuidados paliativos surgem como uma filosofia de cuidados para melhorar a qualidade de vida dos pacientes e seus familiares no processo de enfrentamento do fim da vida 5 .…”