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Publication
Suporte nutricional artificial em cuidados paliativos: questões éticas
| Name: | Description: | Size: | Format: | |
|---|---|---|---|---|
| TC_26968 | 348.46 KB | Adobe PDF |
Advisor(s)
Abstract(s)
Os Cuidados Paliativos são o cuidado ativo dos Doentes cuja doença não responde ao tratamento curativo. São cuidados que englobam uma abordagem holística e interdisciplinar, onde se tem em vista não só o Doente, mas também a sua família e a comunidade envolvida. O objetivo principal é preservar a melhor qualidade de vida e conforto até à morte. O Suporte Nutricional Artificial é um dos assuntos mais controversos nesta área do cuidar.
O objetivo deste trabalho foi compreender e discutir as questões éticas relacionadas com o Suporte Nutricional Artificial em Cuidados Paliativos.
Realizou-se uma revisão de literatura, sendo que os artigos analisados referem que a alimentação não tem apenas um significado fisiológico, mas apresenta também um valor simbólico, dado que afeta o estado psicológico e emocional, tendo em consideração as diferenças culturais e crenças espirituais. Quando o Suporte Nutricional Artificial é estabelecido em Cuidados Paliativos, o melhor interesse do Doente deve ser salvaguardado. Para alguns autores, o Suporte Nutricional Artificial é uma necessidade básica, e desde que o Doente deseje, este deve ser alimentado. Em contrapartida, outros autores consideram que o Suporte Nutricional Artificial corresponde a um tratamento e há determinadas circunstâncias em que é legítimo não iniciar, não manter ou parar a terapêutica. Os artigos referem também, quanto aos princípios bioéticos, que (1) a autonomia reconhece a autodeterminação de cada Doente na decisão de iniciar ou parar o Suporte Nutricional Artificial; (2) o princípio da beneficência diz respeito a que as ações sejam realizados de acordo com os melhores interesses do Doente; (3) o princípio da não-maleficência diz respeito a não fazer dano ao Doente ao iniciar o Suporte Nutricional Artificial e (4) a justiça remete para a importância de dar a cada Doente o mesmo número de possibilidades com os recursos disponíveis. Torna-se também crucial entender a diversidade cultural e religiosa de forma a integrar a Bioética na Nutrição.
Palliative Care is the active, total care of the patients whose disease is not responsive to curative treatment. PC is interdisciplinary in its approach and encompasses the patient, the family and the community in its scope. It sets out to preserve the best possible quality of life and comfort until death. Artificial Nutritional Support remains one of the most controversial issue in Palliative Care. The main purpose of this work was to understand and discuss the ethical questions related to the Artificial Nutritional Support in Palliative Care. This work was based on a literature review and the articles refer that food has not only a physiological meaning but also a symbolic value, affecting our psychological and emotional status, based on our cultural and spiritual believes. When Artificial Nutritional Support in Palliative Care is established, the best interest of the patient must be safeguarded. For some authors, Artificial Nutritional Support is a basic human care and, as long as the patient wants and can be fed, there is an obligation to provide such measure. To other authors it constitutes a medical treatment and there are circumstances in which it is legitimate for them not to start, maintain or stop. The articles also refer that: (1) the principle of autonomy recognizes patients self-determination to decide to start or stop Artificial Nutritional Support; (2) the principle of beneficence is related to the patients’ best interests; (3) the principle of non-maleficence regards doing no harm to patient by beginning Artificial Nutritional Support; and (4) regarding justice, there is the need to give every patients the same number of possibilities with the resources available. Understanding the cultural and religious diversity is necessary to integrate bioethics into nutrition.
Palliative Care is the active, total care of the patients whose disease is not responsive to curative treatment. PC is interdisciplinary in its approach and encompasses the patient, the family and the community in its scope. It sets out to preserve the best possible quality of life and comfort until death. Artificial Nutritional Support remains one of the most controversial issue in Palliative Care. The main purpose of this work was to understand and discuss the ethical questions related to the Artificial Nutritional Support in Palliative Care. This work was based on a literature review and the articles refer that food has not only a physiological meaning but also a symbolic value, affecting our psychological and emotional status, based on our cultural and spiritual believes. When Artificial Nutritional Support in Palliative Care is established, the best interest of the patient must be safeguarded. For some authors, Artificial Nutritional Support is a basic human care and, as long as the patient wants and can be fed, there is an obligation to provide such measure. To other authors it constitutes a medical treatment and there are circumstances in which it is legitimate for them not to start, maintain or stop. The articles also refer that: (1) the principle of autonomy recognizes patients self-determination to decide to start or stop Artificial Nutritional Support; (2) the principle of beneficence is related to the patients’ best interests; (3) the principle of non-maleficence regards doing no harm to patient by beginning Artificial Nutritional Support; and (4) regarding justice, there is the need to give every patients the same number of possibilities with the resources available. Understanding the cultural and religious diversity is necessary to integrate bioethics into nutrition.
Description
Trabalho Complementar apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de licenciada em Ciências da Nutrição
Keywords
Ética Cuidados paliativos Fim de vida Suporte nutricional Ethics Palliative care End of life Nutritional support