In addition to a legal obligation (Law 41/2002), informing patients in a truthful, intelligible and appropriate way about their diagnosis and prognosis is an ethical and deontological duty. We propose to briefly outline some aspects of an ethical nature that, necessarily, must be taken into account when elucidating this final process in order to guarantee, at all times, respect for the inherent dignity of the patient and, in turn, ensure maximum quality and maximum well-being during the last phase of their lives. We are not intending to enter into the casuistic analysis, which is part of a healthcare ethics committee. The expression “to accompany to die with dignity” is a desideratum that shelters practices and decisions of very different nature and, sometimes, legitimizes actions located on opposite sides.
#Ethical issues in end of life decisions professional
However, this professional duty opens a range of interpretations and practices based on the contexts, the actors involved and the beliefs and values of the professional, the patient and their family. To seek a peaceful death taking into account the system of values and beliefs of the patient constitutes an ethical imperative. It is a duty of the ethics of health professionals, doctors, nurses and the whole technical body, to accompany the patient to die with dignity, to scrupulously respect their decisions and to alleviate all manifestations of pain and suffering. 4–7 There are usually situations of great technological complexity and very emotional that require the discernment of entities of interdisciplinary deliberation, such as health care ethics committees.
The management of this process generates ethical dilemmas that require a careful and respectful look to the person's dignity. The end-of-life process is a particularly complex field in technologically developed societies. In this paper we intend to present comprehensive and coordinated ethical, medical and legal aspects in this respect, so that health professionals have the necessary updating to act according to the lex artis, in the current legislation, and to promote reflection in the profession on this matter, in anticipation of potential future changes in regulation. Although it is not the first time that this debate has reached the Congress of Deputies, several political parties have recently submitted motions to address the end-of-life conditions, including decriminalizing euthanasia in one of these motions. In recent months, the political debate about dignified death has been significantly intensified in Spain. This, together with the aging of the population, assistance to people with advanced chronic diseases and fragile patients, underlines the relevance of this debate. The advances of medicine and other related sciences entail the extension or maintenance of a person's life to limits unsuspected a few years ago. From perspectives in various fields, such as political, legal, ethical or medical-legal perspective, a debate and the contribution of new concepts arise. Progressively the issues related to the end-of-life process have gained interest in the last decade in our country. Medicina Clínica is included in the General and Internal Medicine category of Thomson Reuters. The journal adheres to the standards of academic research publications in all aspects including peer-review and ethical principles. These manuscripts contain updated topics with a major clinical or conceptual relevance in modern medicine. Medicina Clínica is predominantly interested in publishing original research manuscripts, which are rigorously selected according to their quality, originality, and interest, and also in continued medical education-oriented manuscripts, which are commissioned by the journal to relevant authors (Editorials, Reviews, and Diagnosis and Treatment). The key characteristics of Medicina Clínica are the scientific and methodological rigor of its manuscripts, the topicality of its contents, and, especially, its practical focus with highly useful information for clinical practice. Launched in 1943, Medicina Clínica is a fortnightly journal aimed at the promotion of clinical research and practice among internal medicine and other specialists.
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