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Integrating palliative care and Intensive care: a spectrum of ethical issues

dc.contributor.authorPereira, Sandra Martins
dc.contributor.authorTeixeira, Carla
dc.contributor.authorCarvalho, Ana Sofia
dc.contributor.authorHernández-Marrero, Pablo
dc.date.accessioned2019-07-10T11:01:32Z
dc.date.available2019-07-10T11:01:32Z
dc.date.issued2018
dc.description.abstractBackground: The integration of palliative care (PC) in intensive care (IC) can be framed ethically. By integrating the core principles of PC in IC, the ethical principles of autonomy, beneficence, non-maleficence and justice are fostered together with the ethical principles of dignity, integrity and vulnerability. Several organizational initiatives have been described worldwide on integration. Little is known on the ethical principles supporting this integration. Aims: To ethically frame and understand healthcare professionals’ perspectives about integrating PC and IC. Methods: A qualitative study, using in-depth interviews to collect data from healthcare professionals working in Portuguese PC and IC units. Data is being analysed using a thematic analysis approach. A snowball sampling procedure is being applied until reaching theoretical saturation. Up-to-date, 22 professionals (8 physicians and 14 nurses) across settings and cities were interviewed. Results: Participants understand the integration of PC in IC as a way of improving end of life care and end of life decision-making processes. In their speech, an early integration of PC is needed, particularly in other settings (e.g., medical and surgical) in order to prevent invasive interventions and admissions in IC units. This is linked to the application of the ethical principles of beneficence, non-maleficence and justice into practice. Professionals also consider that the integration of PC in IC may foster patient autonomy, by allowing patients to be cared for and die in their place of preference, and integrity, through a holistic approach. Patients in IC are particularly vulnerable; integrating the principles of PC can protect them of any further harm. While professionals working in PC consider that integration should be promoted by implementing a mixed-organizational model, professionals from IC units defend an educational model, which should be promoted during medical specialty training as intensivists, PC being part of this education programme. Conclusions: This is the first study addressing the integration of PC in IC in Portugal, following an ethical frame. Professionals working in PC and IC seem to have different perspectives on how the integration model should be. Findings show the potential for a successful integration; more research is needed to develop an effective, sustainable and ethically sound integration model. Acknowledgments: Fundação Grünenthal and Fundação Merck, Sharp and Dohme.
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationPereira, S.M., Teixeira, C., Carvalho, A.S., Hernández-Marrero, P. (2018). Integrating Palliative Care and Intensive Care: A Spectrum of Ethical Issues. In Palliative Medicine, 32(1sup.),184-185pt_PT
dc.identifier.issn0269-2163
dc.identifier.urihttp://hdl.handle.net/10400.14/27902
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.rights.uriN/A
dc.titleIntegrating palliative care and Intensive care: a spectrum of ethical issuespt_PT
dc.typeconference object
dspace.entity.typePublication
oaire.citation.endPage185
oaire.citation.issue1 sup.
oaire.citation.startPage184
oaire.citation.titlePalliative Medicine
oaire.citation.volume32
person.familyNameMartins Pereira
person.familyNameTeixeira
person.familyNameCarvalho
person.familyNameHernández-Marrero
person.givenNameSandra
person.givenNameCarla
person.givenNameAna Sofia
person.givenNamePablo
person.identifierN-3873-2015
person.identifier.ciencia-idA61F-CDBA-4EE2
person.identifier.ciencia-id6410-E2E3-9D74
person.identifier.ciencia-idFA1A-47B9-5AE5
person.identifier.orcid0000-0003-4113-8957
person.identifier.orcid0000-0002-9581-0756
person.identifier.orcid0000-0003-1132-8880
person.identifier.orcid0000-0002-8893-3491
person.identifier.ridN-3890-2015
person.identifier.ridI-4333-2014
person.identifier.ridN-3873-2015
person.identifier.scopus-author-id24169551000
person.identifier.scopus-author-id55908810500
person.identifier.scopus-author-id38560931500
person.identifier.scopus-author-id16417188300
rcaap.rightsrestrictedAccesspt_PT
rcaap.typeconferenceObjectpt_PT
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