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End-of-life decision making in palliative care and recommendations of the council of Europe: qualitative secondary analysis of interviews and observation field notes

dc.contributor.authorPereira, Sandra Martins
dc.contributor.authorFradique, Emília
dc.contributor.authorHernández-Marrero, Pablo
dc.date.accessioned2019-07-09T14:00:39Z
dc.date.available2019-07-09T14:00:39Z
dc.date.issued2018
dc.description.abstractBackground: End-of-life decisions (ELDs) are embedded in clinical, sociocultural, political, economic, and ethical concerns. In 2014, the Council of Europe (CoE) through its Committee on Bioethics launched the ‘‘Guide on the decision-making process regarding medical treatment in end-of-life situations,’’ aiming at improving decision-making processes and empowering professionals in making ELDs. Objective: To analyze if end-of-life decision making in palliative care (PC) is consistent with this Guide and to identify if disputed/controversial issues are part of current ELDs. Design: Qualitative secondary analysis Setting/Subjects: Four qualitative datasets, including 44 interviews and 9 team observation field notes from previous studies with PC teams/professionals in Portugal. Measurements: An analysis grid based on the bovementioned guide was created considering three dimensions: ethical and legal frameworks, decision-making process, and disputed/controversial issues. Results: The majority of the professionals considered the ethical principle of autonomy paramount in end-of-lif decision making. Justice and beneficence/nonmaleficence were also valued. Although not mentioned in the Guide, the professionals also considered other ethical principles when making ELDs, namely, responsibility, integrity, and dignity. Most of the interviewees and field notes referred to the collective interprofessional dimension of the decision-making process. Palliative sedation and the wish to hasten death were the most mentioned disputed/controversial issues. The nature, limitations, and benefits of qualitative secondary analysis are discussed. Conclusions: End-of-life decision-making processes made by Portuguese PC teams seem to be consistent with the guidelines of the CoE. Further research is needed about disputed/controversial issues and the actual use, effectiveness, and impact of ethical guidelines for end-of-life decision making on professionals’ empowerment and for all parties involved.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationPereira, S. M., Fradique, E., Hernández-Marrero, P. (2018). End-of-life decision making in palliative care and recommendations of the council of Europe: Qualitative secondary analysis of interviews and observation field notes. Journal of Palliative Medicine, 21(5), 604-615pt_PT
dc.identifier.doi10.1089/jpm.2017.0403pt_PT
dc.identifier.eid85046903954
dc.identifier.eissn1557-7740
dc.identifier.issn1096-6218
dc.identifier.pmid29742044
dc.identifier.urihttp://hdl.handle.net/10400.14/27875
dc.identifier.wos000419398000001
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherMary Ann Liebert, Inc.pt_PT
dc.subjectAdvance directivespt_PT
dc.subjectDecision makingpt_PT
dc.subjectEnd of lifept_PT
dc.subjectEthical guidelinespt_PT
dc.subjectEthical principlespt_PT
dc.subjectEthicspt_PT
dc.subjectPalliative carept_PT
dc.subjectPalliative sedationpt_PT
dc.subjectQualitative secondary analysispt_PT
dc.subjectWish to hasten deathpt_PT
dc.titleEnd-of-life decision making in palliative care and recommendations of the council of Europe: qualitative secondary analysis of interviews and observation field notespt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage615
oaire.citation.issue5
oaire.citation.startPage604
oaire.citation.titleJournal of Palliative Medicinept_PT
oaire.citation.volume21
person.familyNameMartins Pereira
person.familyNameHernández-Marrero
person.givenNameSandra
person.givenNamePablo
person.identifierN-3873-2015
person.identifier.ciencia-idFA1A-47B9-5AE5
person.identifier.orcid0000-0003-4113-8957
person.identifier.orcid0000-0002-8893-3491
person.identifier.ridN-3890-2015
person.identifier.ridN-3873-2015
person.identifier.scopus-author-id24169551000
person.identifier.scopus-author-id16417188300
rcaap.rightsrestrictedAccesspt_PT
rcaap.typearticlept_PT
relation.isAuthorOfPublication60b77242-ab9e-45f4-8f73-3e6b67d68067
relation.isAuthorOfPublication0bcd4bfb-7d66-4cfc-8516-3744378fb35e
relation.isAuthorOfPublication.latestForDiscovery60b77242-ab9e-45f4-8f73-3e6b67d68067

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