Abstract
BackgroundEthical problems about end-of-life medicine include a variety of issues approached in different ways by physicians and, more recently, special emphasis to this kind of ethical issues and possible answers has done by Italian National Ethical Committee in the issue named “Deep and continuous palliative sedation in the imminence of Death” (January, 2016). The debate is very critical in Intensive Care Units and Cancer Wards, where health care professionals face-off with terminally-ill patients is an outright routine; the Authors investigated their medical knowledge and ethical perception about patient critical and terminal condition to discuss the most relevant conclusions.MaterialIn the Sicilian province of Palermo, physicians working in Intensive Care and Oncology fields were been given a questionnaire that takes inspiration from the Ethicatt Questionnaire-Doctor. The authors reported the results obtained, by selecting and analyzing the most involved questions about living wills.ResultsGenerally, the respondents showed a great sensibility on this topic. Overall agreement on the living will was observed, as past surveys, but also a new conception. Euthanasia remains not very popular, attitude in line with other countries. Opinions and aptitudes of relatives have minor importance towards patient’s wishes, that are in some cases in first place.ConclusionExplicit positive answer towards dilemmas about living wills lifts the veil and reveals how these ones would represent a very useful tool for health care professionals in this study. It is also plausible that, if doctors had available an advance directive (living will) document, they would follow it, overcoming any contingent ethical objections.
Highlights
Ethical problems about end-of-life medicine include a variety of issues approached in different ways by physicians and, more recently, special emphasis to this kind of ethical issues and possible answers has done by Italian National Ethical Committee in the issue named “Deep and continuous palliative sedation in the imminence of Death” (January, 2016)
Existing dilemmas concerning end-of-life medicine – as issues about patient informed consent for life-saving treatments, or attitudes of medical professionals towards decision-making about do not start or suspend lifesustaining/prolonging care – today more than ever are becoming crucial (Müller-Busch et al, 2004), especially whereas the comparison is between doctors and critical/ terminally-ill/unconsciousness patients, as at Intensive Care Units (ICUs) and Cancer Wards, where this opposition may be an outright routine
The first three questions we analyse regard the opinion of the physician about people to involve in the decisionmaking process (Questionnaire, items 1-3)
Summary
Ethical problems about end-of-life medicine include a variety of issues approached in different ways by physicians and, more recently, special emphasis to this kind of ethical issues and possible answers has done by Italian National Ethical Committee in the issue named “Deep and continuous palliative sedation in the imminence of Death” (January, 2016). Existing dilemmas concerning end-of-life medicine – as issues about patient informed consent for life-saving treatments, or attitudes of medical professionals towards decision-making about do not start or suspend lifesustaining/prolonging care – today more than ever are becoming crucial (Müller-Busch et al, 2004), especially whereas the comparison is between doctors and critical/ terminally-ill/unconsciousness patients, as at Intensive Care Units (ICUs) and Cancer Wards, where this opposition may be an outright routine. We considered significant opinions of physicians towards life-saving treatments in the case of terminally or dying patients, when deep sedation could be necessary.
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