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[The anesthesiologist facing terminality: a survey-based observational study].

Rodney Segura Cavalcante1, Guilherme Antonio Moreira de Barros2, Eliana Marisa Ganem3

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Summary

Brazilian anesthesiologists prefer orthothanasia (natural death) for end-of-life care, prioritizing dignity, despite often practicing dysthanasia (prolonging dying). Medical education inadequately prepares them for these complex issues.

Keywords:
AnestesiologiaAnesthesiologyBioethicsBioéticaDistanásiaDysthanasiaLegalidade (Direito)Legality (Law)

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Area of Science:

  • Medical Ethics
  • Anesthesiology
  • End-of-Life Care

Background:

  • Medical advancements have made natural death rare, leading to the common practice of dysthanasia without clear rationale.
  • Dysthanasia, the practice of prolonging the dying process, is prevalent in modern medicine.
  • Orthothanasia, allowing natural death, is an alternative approach to end-of-life care.

Purpose of the Study:

  • To assess Brazilian anesthesiologists' knowledge of dysthanasia and orthothanasia.
  • To investigate their management preferences regarding these end-of-life practices.
  • To evaluate the role of medical school in addressing death-related issues.

Main Methods:

  • A prospective, descriptive cohort study involving 150 anesthesiologists from the Brazilian Society of Anesthesiology.
  • Data collection via an online questionnaire with 38 questions.
  • Study approved by the Instructional Research Ethics Committee.

Main Results:

  • Anesthesiologists prefer orthothanasia (dying at home with dignity) for themselves and loved ones, yet report practicing dysthanasia, causing distress.
  • Most acquired knowledge on end-of-life care outside of medical school and were unaware of relevant medical council resolutions.
  • Undergraduate training on end-of-life issues was lacking, despite self-perceived capability in identifying such situations.

Conclusions:

  • Anesthesiologists express a preference for orthothanasia but frequently practice dysthanasia, leading to negative emotional outcomes.
  • There is a significant gap in medical school curricula regarding the management of death and dying.
  • Medical education needs improvement to better equip professionals for end-of-life care discussions and practices.