Nursing care in terminality: compliance with principles of bioethics

Abstract

The aim of the study was to investigate the principles of bioethics reported by nurses when caring for terminally ill patients. Exploratory research with qualitative approach, developed with fifteen nurses from an intensive care unit of a university hospital, in northeastern Brazil. Data collection was conducted between March and July 2013, through a form. Data were analyzed using the technique of content analysis, emerging the following thematic category: respect to the principles of autonomy, beneficence, non-maleficence and justice to take care of the terminally ill patients. The participating nurses valued these principles when caring for terminally ill patients, which reflect the ethical commitment of these professionals in the practice of nursing care. It is noteworthy that bioethical principles should guide the nursing care of human beings throughout their life cycle.

Cultural Adaptation and Validation of the Moral Sensitivity Questionnaire Among Brazilian Nurses

“…The original MSQ comprises 30 questions validated in six constructs: interpersonal orientation, structuring moral meaning, expressing benevolence, modified autonomy, experiencing moral conflict, and knowledge in medical and nursing knowledge. 4 The Brazilian version comprises 18 questions validated in six constructs: respect for patients' autonomy, modified autonomy, experiencing moral conflict, having knowledge in medical and nursing knowledge, structuring moral meaning, and teamwork.…”

“…17 In this context, nurses can seek elements that facilitate bonding, interactions and care actions intended to advocate for the patients' autonomy. 18 Autonomy, a right of every human being, is expressed in the ability to act and make decisions that are based on one's values, considering what is best for oneself. 19…”

Dilemas bioéticos experimentados por el cuidador respiratorio durante el retiro de la ventilación mecánica en adultos al final de la vida.

“…Paralelamente, los profesionales deben analizar las situaciones a la luz del principio de la inviolabilidad de la vida humana, el de la veracidad (informar la verdad al paciente sobre su condición), el de prevención (evitar las complicaciones utilizando las medidas necesarias para preservar al paciente), el de no abandono (no dejar de prestar atención sanitaria a pesar de que el paciente rechace el tratamiento) (Rojas et al, 2019b), el de no maleficencia (no causar daño físico, psíquico, moral y/o económico), el de justicia (selección equitativa de las personas en enfermedad terminal), el de autonomía (derecho a la libertad de los individuos y el respeto sus preferencias), finalmente, el derecho a la beneficencia (garantizar el bienestar de los individuos) (Chotirmall et al, 2010); (C & Javier, 2012); (García, 2018b). Cuando sus decisiones giren en torno a los cuidados paliativos primaran los principios bioéticos de beneficencia, no maleficencia, autonomía y justicia, porque los procedimientos en pacientes terminales requieren de una atención minuciosa, sensible y humanizada, además de garantizar el alivio de dolor físico y el apoyo espiritual (Chaves et al, 2011); (Felix et al, 2014); (Kovács, 2014); (Pereáñez, 2017); (Medeiros et al, 2020).…”

Conflitos bioéticos nos cuidados de fim de vida

“…However, orthothanasia, which also stresses patients' autonomous decision to have a more natural and painless death, has gained ground in multiprofessional care, especially in the field of nursing 16 . Thus, bioethical principles contribute to guide medical ethics, supporting humanized initiatives in palliative care and ensuring the dignity of terminal patients 20,21 .…”