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Ethical Dilemmas in Hospice and Palliative Care Units for Advanced Cancer Patients

Year 2013, Volume: 22 Issue: 1, 65 - 79, 01.03.2013

Abstract

Ethical dilemmas that face heathcare team members referring patients to hospice programs include the ability of clinicians to predict accurately a patient bad prognosis. They affect day-to-day patient management in palliative care programs including healthcare team members concern over the use of morphine because possible respiratory depression in the patient, the question of providing enteral or parenteral nutritional support to patients who refuse to eat and the question of providing parenteral fluids to patients who are unable to take fluids during the terminal phrases of illness. A final ethical dilemma concerns the methodology for quality of life research in palliative care. Understanding and resolving these ethical dilemmas is an important factor determining the quality of the caring for the patient. The ethical dilemmas that are discussed in the article likely to occur in this period can be prevented through his/her participation in the decisions concerning his or her treatment.

References

  • Coyle N, Adelhard J, Foley KM. Character of terminal illness in the advanced cancer patients: pain and other symptoms during the last four week of life. J Pain Sympt Manage. 1990; 5:83-93. McMillan SC, Small BJ. Symptom distress and quality of life in patients with cancer newly admitted to hospice home care. Oncol Nurs Forum. 2002; 29;1421-28.
  • Daugherty CK. Examining ethical dilemmas as obstacles to hospice and palliative care for advanced cancer patients. Cancer Invest. 2004;22:123-31.
  • Stjernsward J, Clark D. Palliative medicine e a global perspective. In: Doyle D, Hanks G, Cherny, N, Calman K, eds. Oxford textbook of palliative medicine, 2nd ed. Oxford, Oxford University Press 2003;1199-224.
  • Saunders C. The founding philosophy. In: Saunders C, Summers DH, Teller N (Eds). Hospice the Living Idea. Washington DC, WC Saunders, 1981.
  • National Quality Forum. A national framework and preferred practices for palliative and hospice care quality. Washington, DC, National Quality Forum, 2006.
  • Raynes NV, Leach JM, Rawlings B, Bryson RJ. Using focus groups to seek the views of patients dying from cancer about the care they receive. Health Expect. 2000; 3:169-75.

İleri Evre Kanser Hastalarına Yönelik Hospis ve Palyatif Bakım Ünitelerinde Etik Sorunlar

Year 2013, Volume: 22 Issue: 1, 65 - 79, 01.03.2013

Abstract

Palyatif ve hospis programlarında bulunan hastalarla ilgili sağlık personelinin karşı karşıya kaldığı etik sorunlar çoğunlukla hastanın kötü prognozuyla ilişkilidir. Bu programlarda bulunan terminal dönemdeki kanser hastalarıyla ilgili olarak sağlık personelinin günlük olarak karşı karşıya kaldığı etik ikilemler arasında morfin uygulamaları, oral yolla beslenmesi mümkün olmayan hastalar için enteral ve parenteral beslenmenin hasta tarafından ret edilmesi sayılabilir. Ayrıca bu hastalarda yaşanması olası diğer bir etik ikilem bu merkezlerde bulunan hastaların yaşam kalitesi düzeyleridir. Tüm bunlar, bu merkezlerde terminal dönemdeki kanser hastalarının bakım ve tedavisinden sorumlu sağlık personelinin karsılaşabileceği etik sorunlardan sadece bazılarıdır. Yaşanılması olası bu etik ikilemlerin sağlık personeli tarafından anlaşılması ve çözüm önerilerinin getirilebilmesi tedavi ve bakım kalitesini artıracaktır. Nitekim palyatif ve hospis bakım merkezlerinin ana hedefler arasında hastalara yaşam kalitesi yüksek bir bakım sunarak huzurlu bir ölümün sağlanmasıdır. Bu yazıda sözü edilen sağlık personelinin terminal dönemdeki hastalarda karşılaşılabileceği etik sorunların hastaların kendileriyle ilgili tedavi ve bakım kararlarının katılımlarının sağlanmasıyla önlenebileceğini düşünüyoruz.

References

  • Coyle N, Adelhard J, Foley KM. Character of terminal illness in the advanced cancer patients: pain and other symptoms during the last four week of life. J Pain Sympt Manage. 1990; 5:83-93. McMillan SC, Small BJ. Symptom distress and quality of life in patients with cancer newly admitted to hospice home care. Oncol Nurs Forum. 2002; 29;1421-28.
  • Daugherty CK. Examining ethical dilemmas as obstacles to hospice and palliative care for advanced cancer patients. Cancer Invest. 2004;22:123-31.
  • Stjernsward J, Clark D. Palliative medicine e a global perspective. In: Doyle D, Hanks G, Cherny, N, Calman K, eds. Oxford textbook of palliative medicine, 2nd ed. Oxford, Oxford University Press 2003;1199-224.
  • Saunders C. The founding philosophy. In: Saunders C, Summers DH, Teller N (Eds). Hospice the Living Idea. Washington DC, WC Saunders, 1981.
  • National Quality Forum. A national framework and preferred practices for palliative and hospice care quality. Washington, DC, National Quality Forum, 2006.
  • Raynes NV, Leach JM, Rawlings B, Bryson RJ. Using focus groups to seek the views of patients dying from cancer about the care they receive. Health Expect. 2000; 3:169-75.
There are 6 citations in total.

Details

Primary Language Turkish
Journal Section Review
Authors

Beyhan Bag This is me

Nesrin Reis This is me

Publication Date March 1, 2013
Published in Issue Year 2013 Volume: 22 Issue: 1

Cite

AMA Bag B, Reis N. İleri Evre Kanser Hastalarına Yönelik Hospis ve Palyatif Bakım Ünitelerinde Etik Sorunlar. aktd. March 2013;22(1):65-79.