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Challenges to implementation of advance directives of will in hospital practice
Silvana Bastos Cogo1, Valéria Lerch Lunardi1, Alberto Manuel Quintana2
1Universidade Federal do Rio Grande, Programa de Pós-Graduação em Enfermagem. Rio Grande-RS, Brasil.
Objective::
to understand the difficulties and limitations in the implementation of advance directives of will in the hospital context.
Method::
qualitative, exploratory and descriptive study conducted by means of semi-structured interviews with nurses, resident physicians and family caregivers. The data were analyzed by using discursive textual analysis based on the framework of bioethics principles.
Results::
the following categories emerged: Terminality as an expression of loss and cure as an option for care; concerns about legal implications; advance directives of will demand patient autonomy and proper communication.
Conclusion::
limitations and difficulties in practice of advance directives of will from the perspective of the participants show, apart from countless conflicts and dilemmas regarding end-of life matters, that impending death experiences obstruct patients' wishes.
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