Análisis de una experiencia de consultoría ético clínica en cuidado intensivo
Autor: | Alejandro Koppmann A, Sebastián Solar P, Pamela Chávez B, Juan Pablo Beca I, Iris Delgado B |
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Rok vydání: | 2010 |
Předmět: |
Ethics Committees
clinical Ethics medical medicine.medical_specialty Intensive care units business.industry education Ethics committee General Medicine Subrogation Intensive care unit law.invention Consumer satisfaction law Consultation system Family medicine Intensive care medicine Ethics Consultations business Ethics Consultation |
Zdroj: | Revista médica de Chile v.138 n.7 2010 SciELO Chile CONICYT Chile instacron:CONICYT |
ISSN: | 0034-9887 |
DOI: | 10.4067/s0034-98872010000700004 |
Popis: | Background: Very few patients are presented to ethics committees, and individual ethics consultations are a response to this situation. At the intensive care unit (ICU) in Clínica Alemana, Santiago Chile, an ethics consultation system was organized coordinated with the ethics committee. Aim: To report an evaluation of this ethics consultation system. Material and Methods: Analysis of the frst 50 cases analyzed in the consultation system. Analysis of the responses of intensive care physicians to a questionnaire about the main ethical problems that they face in their work. Results: The consultation system is mainly required by the ICU staff, and reports to the ethics committee. Fifty four percent of patients subjected to consultation were aged over 80 years. The main diagnoses were neurological, oncological or cardiopulmonary problems. The ethical problems identifed were treatment limitation (62%), proportionality or futility (42%), need of a peaceful death (36%), lack of anticipated decisions (28%), disagreement between physicians and patients family (24%), undefined subrogation (14%), and abuse of public resources (14%). Twenty six of 31 ICU physicians answered the questionnaire, using a 1 (min) to 7 (max.) scale. They found that consultation is helpful for decision making (6.3), useful for improving ethical perception (6.0), supportive for staff (6.5), good for patients (6.3), supportive for families (6.7), and timely performed (5.2). Conclusions: As a complement for the ethics committees work, consultation is a valid alternative for ethics counselling and a support for physicians and patients families. Its implementation depends on the particularities of each health institution. |
Databáze: | OpenAIRE |
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