[The provision of assisted death in the context of the desire to anticipate death].

Autor:	Busquet-Duran X; Programa d'Atenció Domiciliària, Equip de Suport (PADES). Servei d'Atenció Primària Vallès Oriental, Institut Català de la Salut, Granollers, Barcelona, España; Unitat de Suport a la Recerca Metropolitana Nord, Institut Universitari d'Investigació en Atenció Primària (IDIAP Jordi Gol), Mataró, Barcelona, España. Electronic address: xbusquet@umanresa.cat., Martínez Losada EJ; Instituto de Investigación en Atención Primaria Jordi Gol, Barcelona, España., Torán-Monserrat P; Unitat de Suport a la Recerca Metropolitana Nord, Institut Universitari d'Investigació en Atenció Primària (IDIAP Jordi Gol), Mataró, Barcelona, España.
Jazyk:	Spanish; Castilian
Zdroj:	Atencion primaria [Aten Primaria] 2024 Sep; Vol. 56 (9), pp. 102895. Date of Electronic Publication: 2024 Mar 27.
DOI:	10.1016/j.aprim.2024.102895
Abstrakt:	The entry into force of the Organic Law on the Regulation of Euthanasia in June 2021 obliges clinicians to reconsider their professional work, in the face of a new service that expands the limits of what was considered correct until then. This new service affects the entire healthcare system, but especially primary care professionals. Beyond the procedural and moral aspects, it is necessary to rethink the assessment of the patient who expresses a wish to die. In this review, we start with the relatively recent definition of the wish to hasten death (WTHD), its causes, epidemiology and differential diagnosis. Then, we examine the different mental frameworks found in the process of dying and the concept of a «good death». Finally, we analyse the paths that can lead to the provision of aid in dying within the framework of current legislation. The WTHD is specific to requests in case of «serious and advanced illness», not in other cases contemplated by the Law. When faced with a request to activate the Aid in Dying Prestation in the context of WTHD (that is, in the proximity of death), it becomes necessary to increase the patient's sense of control and begin to work on grief. Besides, in the face of an administrative process that will necessarily be long, adapting the therapeutic efforts and sedation should be considered as possible options. We understand that it is essential not to create false expectations for patients/families and not to overload healthcare professionals with administrative tasks that will be futile. It is difficult to balance these in the face of a request for a right to which the patient should always have access. (Copyright © 2024 The Author(s). Publicado por Elsevier España S.L.U. All rights reserved.)
Databáze:	MEDLINE
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