Therapeutic Obstinacy in End-of-Life Care-A Perspective of Healthcare Professionals from Romania.

Autor:	Bacoanu G; 2nd Internal Medicine Department, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania.; Department of Palliative Care, Regional Institute of Oncology, 700483 Iasi, Romania., Poroch V; 2nd Internal Medicine Department, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania.; Department of Palliative Care, Regional Institute of Oncology, 700483 Iasi, Romania., Aniței MG; Department of Surgery, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania., Poroch M; Department of Preventive Medicine and Interdisciplinarity, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania., Froicu EM; 2nd Internal Medicine Department, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania.; Medical Oncology Department, Regional Institute of Oncology, 700483 Iasi, Romania., Pascu AM; Faculty of Medicine, Transylvania University of Brasov, 500036 Brasov, Romania., Ioan BG; Legal Medicine Department, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy of Iasi, 700115 Iasi, Romania.; Institute of Legal Medicine of Iasi, 700455 Iasi, Romania.
Jazyk:	angličtina
Zdroj:	Healthcare (Basel, Switzerland) [Healthcare (Basel)] 2024 Aug 10; Vol. 12 (16). Date of Electronic Publication: 2024 Aug 10.
DOI:	10.3390/healthcare12161593
Abstrakt:	Background: End-of-life care raises ethical, moral, legal and economic dilemmas, especially when physicians have to decide whether to initiate or to stop treatments that may be considered disproportionate and futile. Aim: To explore the opinion of health care professionals involved in end-of-life patient care on interventions considered disproportionate and futile at this stage of care, the causes and factors of pressure leading to such situations, and possible solutions to reduce the phenomenon. Material and Method: The study used an adapted, designed questionnaire intended for health professionals caring for patients at the end of life. The 128 respondents were physicians, nurses, psychologists and social workers who expressed their opinions about therapeutic obstinacy in end-of-life care. Results: The results of the research highlight the role of the family as a pressure factor, the causes related to the non-acceptance of the prognosis and diagnosis of a terminal condition, fear of death and ignorance of the patient's wishes. Interventions considered disproportionate at the end of life were cardiopulmonary resuscitation, mechanical ventilation, transfusion of blood derivatives, complex diagnostic investigations and the establishment of gastrostomy/jejunostomy in the last days of life. Conclusions: End-of-life therapeutic obstinacy is a reality in end-of-life care, and healthcare professionals face many ethical challenges in this process. Care decisions must be made together with the patient and their family, respecting the rights, dignity and respect of all parties involved in the process.
Databáze:	MEDLINE
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