ATTITUDES OF MEDICAL STUDENTS TO ETHICAL CONDUCT TOWARDS TERMINALLY ILL PATIENTS (original) (raw)
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Trakia Journal of Sciences, 2010
PURPOSE: to reveal the opinion and attitude of the students in Health Care Management and Nursing undergraduate Bachelors programs concerning the respect of the patients' autonomy by the means of advance directives in case of the oncological disease in its terminal stage.METHODS: An inquiry is instituted in April-May 2010 in the Medical Faculty of Trakia University in Stara Zagora, Bulgaria with 52 students studying in Health Care Management and Nursing undergraduate Bachelors programs. RESULTS: The majority of investigated (76.9%) consider that the respect of free will is justifiable with the principle of respect of autonomy. According to (57.7%) of the answers advance directives (AD) have to be optional in order not to deprive the right of choice. According to (35.5%) of the participants, the patient has to choose the person holding the document-the GP, the family, the oncologists. Having in mind the fact that AD reflects the free will of the patient and confirm the model of autonomy, the patient should initiate working out the document, helped by the clinical psychologist. CONCLUSIONS: This topic is a big challenge for medical specialists and gets his way to improve their qualification in the domain of palliative care.
Trakia Journal of Sciences, 2010
PURPOSE: to reveal the opinion and attitude of the students in Health Care Management and Nursing undergraduate Bachelors programs concerning the respect of the patients’ autonomy by the means of advance directives in case of the oncological disease in its terminal stage.METHODS: An inquiry is instituted in April-May 2010 in the Medical Faculty of Trakia University in Stara Zagora, Bulgaria with 52 students studying in Health Care Management and Nursing undergraduate Bachelors programs. RESULTS: The majority of investigated (76.9%) consider that respect for free will is justifiable with the principle of respect for autonomy. According to (57.7%) of the answers advance directives (AD) have to be optional in order not to deprive the right of choice. According to (35.5%) of the participants, the patient has to choose the person holding the document – the GP, the family, the oncologist. Having in mind the fact that AD reflects the free will of the patient and confirms the model of autonomy, the patient should initiate working out the document, helped by the clinical psychologist. CONCLUSIONS: This topic is a big challenge for medical specialists and gets his way to improve their qualifications in the domain of palliative care.
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-today 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. ÖZET 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
Advance directives in the perception of Medical students
Revista Brasileira de Educação Médica
Evaluated by double blind review process. RESUMO Introdução: A autonomia do paciente na tomada de decisões a respeito da sua vida e das condutas diagnósticas e terapêuticas na sua saúde tem sido objeto de valorização social crescente. As diretivas antecipadas de vontade surgem, então, como um meio de o paciente expressar sua última vontade, salvaguardando o princípio da autonomia. No processo de aprendizagem acadêmica, na maioria das escolas médicas, o acadêmico se compromete com a vida, e toda a sua capacitação é fundamentada em aspectos técnicos, e apenas uma pequena parte do currículo, quando presente, abrange conteúdo específico voltado para a terminalidade da vida. A medicina evoluiu com importantes avanços tecnológicos que resultaram em melhorias na qualidade de vida, porém também trouxeram um prolongamento questionável da vida, com tratamentos muitas vezes injustificáveis e com a obstinação terapêutica de manter a vida a qualquer custo. Objetivo: Este estudo teve como objetivo analisar a percepção de estudantes de Medicina sobre as diretivas antecipadas de vontade. Método: O instrumento de pesquisa foi elaborado com uma entrevista individual e semiestruturada, aplicada pela plataforma de pesquisa Google Forms. Por causa do período de pandemia pelo Sars-CoV-2, a pesquisa foi realizada de forma não presencial em conformidade com a legislação vigente nacional. Após fechamento da amostra por exaustão, analisaram-se as respostas de 13 estudantes. Resultado: Em conformidade aos elementos, passos e critérios metodológicos, as informações obtidas foram classificadas e dispostas em duas categorias: dignidade da pessoa humana e autonomia do paciente; e conhecimento sobre diretivas antecipadas de vontade. Conclusão: Essa análise qualitativa trouxe à tona importantes temas, como a regulamentação que norteia as diretivas antecipadas de vontade e os princípios que envolvem a bioética, a fim de consolidar o respeito, a autonomia e a dignidade do paciente que está, ou estará, passando pela terminalidade da vida.
Advance Directives by Terminally Ill Patients: A Grounded Theory
2019
Truth, death is inevitable. With life comes death and it is only a matter of when and how. The how part always come in either of the three, by accident, old age or disease. And most often than not it is disease which caused most deaths in the world. This study is focused on determining the effects of terminal illness in every aspect of a patient’s life and the advantages and disadvantages of advance directives in their decision-making for their health care administration. The researchers used a single group of 10 respondents suffering from terminal illness, from different cities and municipalities in Batangas. The primary gathering instrument used by the researchers was personal interview of the informants structured interview for a more focused collection of the necessary data. As can be gleaned from the responses of the participants to the questions propounded to them regarding their illness in relation to advance directives, the researchers were able to draw themes which are Adva...
The Malaysian Journal of Medical Sciences : MJMS, 2021
An Advance Medical Directive (AMD) is a document in which competent patients express their wishes regarding their preferred choice of future medical plans in the event they become incompetent. AMD is important in relation to the patient’s right to refuse treatment. However, they must also consider cultural and religious values of different communities. In Islam, there are several concerns that need to be addressed, namely the validity of the AMD according to Islamic jurisprudence and patients’ right to end-of-life decision-making. To address these concerns, this article refers to multiple sources of Islamic jurisprudence, such as the Quran, the tradition of Prophet Muhammad and the works of Islamic scholars related to this topic. Based on the findings, Islam does not forbid the use of AMD as a method to honour patients’ wishes in their end-of-life care. Islamic jurisprudence emphasises on the importance of seeking patients’ consent before carrying out any medical procedures. However...
The Nursing Students' Views About the Patient's Rights at the West Black Sea Universities in Turkey
Nursing and midwifery studies, 2014
The members of healthcare team have an important role in implementation and protection of patient's rights. Contemporary nursing entails an ethical responsibility to advocate and protect the patients' rights. Objectives: This study was designed to evaluate how ready nursing students, at the end of their education, were to play the role of patient's rights advocates and to discuss ethics education in nursing.
Bangladesh Journal of Bioethics, 2016
This baseline study was conducted to find out the knowledge, attitudes and practices of medical ethics among the undergraduate medical interns who did not have structured ethics curriculum in their course. A descriptive, cross-sectional study was carried out using a selfadministered structured questionnaire among the medical undergraduate interns of Maharajgunj Medical Campus, the pioneer medical college of Nepal which enrols 60 students in a year. A total of 46 interns participated in the study. The most common source of knowledge on ethics was lectures/seminars (35.7%) followed by experience at work (24.5%), training (21.4%) and own reading (17.3%). The main contents of Hippocratic Oath were known to 98.8% while 60.9% knew the main contents of Nepal Medical Council (NMC) code of ethics. Great majority (91.3%) regard ethics as very important in medical profession. "Doctors know the best irrespective of patients' opinion" was disagreed by only 39.1% indicating the paternalistic attitude. However, 78.3% were in favour of adhering to the patient's wish. None of the participant agreed to abandon confidentiality. Only about one-fourth (26.1%) claim to encounter ethical dilemma every day while the highest number (43.5%) had once in a month. To deal with the situation of ethical dilemma, majority approached to immediate supervisor followed by head of the department and colleagues. Eighty-seven percent of participating interns were involved in research activities involving human subjects. Only one of the participants had encountered the ethical issue on endof-life and it was do-not-resuscitate consent in a terminally ill patient. On implementation of the curriculum on medical ethics focus should be-principles of biomedical ethics, sensitive ethical dilemmas like end-of-life care and practical experiences with participation in deliberations of the ethics committee.