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A bioethical perspective on the meanings behind a wish to hasten death: a meta-ethnographic review

dc.contributor.authorBorges, Paulo J.
dc.contributor.authorHernández-Marrero, Pablo
dc.contributor.authorPereira, Sandra Martins
dc.date.accessioned2024-02-28T12:51:28Z
dc.date.available2024-02-28T12:51:28Z
dc.date.issued2024-02-27
dc.description.abstractBackground: The expressions of a “wish to hasten death” or “wish to die” raise ethical concerns and challenges. These expressions are related to ethical principles intertwined within the field of medical ethics, particularly in end-of-life care. Although some reviews were conducted about this topic, none of them provides an in-depth analysis of the meanings behind the “wish to hasten death/die” based specifically on the ethical principles of autonomy, dignity, and vulnerability. The aim of this review is to understand if and how the meanings behind the “wish to hasten death/die” relate to and are interpreted in light of ethical principles in palliative care. Methods: We conducted a meta-ethnographic review according to the PRISMA guidelines and aligned with Noblit and Hare’s framework. Searches were performed in three databases, Web of Science, PubMed, CINAHL, with no time restrictions. Original qualitative studies exploring the meanings given by patients, family caregivers and healthcare professionals in any context of palliative and end-of-life care were included. A narrative synthesis was undertaken. PROSPERO registration CRD42023360330. Results: Out of 893 retrieved articles, 26 were included in the analysis, accounting for the meanings of a total of 2,398 participants. Several factors and meanings associated with the “wish to hasten death” and/or “wish to die” were identified and are mainly of a psychosocial and spiritual nature. The ethical principles of autonomy and dignity were the ones mostly associated with the “wish to hasten death”. Ethical principles were essentially inferred from the content of included articles, although not explicitly stated as bioethical principles. Conclusions: This meta-ethnographic review shows a reduced number of qualitative studies on the “wish to hasten death” and/or “wish to die” explicitly stating ethical principles. This suggests a lack of bioethical reflection and reasoning in the empirical end-of-life literature and a lack of embedded ethics in clinical practice. There is a need for healthcare professionals to address these topics compassionately and ethically, taking into account the unique perspectives of patients and family members. More qualitative studies on the meanings behind a wish to hasten death, their ethical contours, ethical reasoning, and implications for clinical practice are needed.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.doi10.1186/s12910-024-01018-ypt_PT
dc.identifier.eid85186179737
dc.identifier.issn1472-6939
dc.identifier.pmcPMC10898028
dc.identifier.pmid38413954
dc.identifier.urihttp://hdl.handle.net/10400.14/44092
dc.identifier.wos001177922200001
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/pt_PT
dc.subjectWish to hasten deathpt_PT
dc.subjectWish to diept_PT
dc.subjectEnd-of-life carept_PT
dc.subjectEthicspt_PT
dc.subjectEthical issuespt_PT
dc.subjectPrinciple based ethicspt_PT
dc.subjectAutonomypt_PT
dc.subjectDignitypt_PT
dc.subjectVulnerabilitypt_PT
dc.subjectMeta-ethnographypt_PT
dc.titleA bioethical perspective on the meanings behind a wish to hasten death: a meta-ethnographic reviewpt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.titleBMC Medical Ethicspt_PT
oaire.citation.volume25pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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