Os portugueses e o Testamento Vital

Abstract

Introduction: It has taken some years since the law (25/2012) was passed and we still do not know about the portuguese population s knowledge regarding the Living Will (LW), nor the law effects. Aim; To identify the Portuguese population fraction that believes to know what the LW is and, from those, the fraction that actually knows what it is; to classify the information resources that allowed the Portuguese to know the LW; to identify the number of Portuguese citizens who made the LW and those who registered it in RENTEV; to identify the reasons that led the Portuguese to perform, or not, the living will; to analyze witch factors may influence the knowledge about the law and the decision of doing the LW. Methods:Stratified random sampling, in order to be representative of the portuguese population over 18 years (n=1064); Analytical, cross-sectional, observational study; It has been done trough face-by-face interviews performed. Results: Only 22% of Portuguese Citizens know what Living Will is; This lack of knowledge is not influenced by gender, age or familiar conditions, but it appears to be influenced (p<0.05) by the regional area along the country. The education seems to influence the knowledge about the LW. The ones who have a high level education are those who know more. Respondents reported that the media was the main information source about this document – law (66.2%); Family doctors were responsible for 2.8% of the information and Nurses for only 2.9%. From the 22% that know what Living Will is, only 50.4% know how to do it and who to ask for help. So, only one in ten portuguese know what LW is, how to do it and who to ask for help. Only 1.4 % of the respondents say that have already done the LW, with no registration in the RENTEV; All of those say that had included specific instructions regarding medical care and two thirds (2/3) also included an Healthcare proxy. From those who had not performed the LW 32% think about doing it; 41.1% choose not to do it; 26.1% do not know yet and are not thinking about doing it. The district size and gender do not influence with statistical significance. All of other factors influence de decision about to do or not to do the living will. From the respondents who intend to do the LW, 17.6% want to include that they do not want to be submitted to any futile treatment. Also from this 16.2% intend to authorize the participation in clinical trials; 13.2%, do not want to be submitted to artificial life support; 10.3% wishes to have palliative care; 4.4% does not want to be part of scientific research programs or clinical trials. From the respondents who do not intend to do the LW, 63.5% justify their choice by have not thought about it yet: 22.4% accept life at each moment; 2.4% by mistrusting the healthcare system and its professionals; 11.8% pointed other reasons. Conclusions: There is significant deficit of knowledge about the LW – regarding, not only, the portuguese society, but also the healthcare providers who should never dismiss this responsibility. On the other hand, the respondents who know what LW is did not obtain this knowledge by healthcare providers. In our opinion, because the living will is about healthcare wishes, we consider that the healthcare providers should be the main information source.