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Nueva Directiva Anticipada de VSED: Avances, pero Persisten Problemas

Jordan Potter1, Christopher Masciari1

  • 1Ethics Department, https://ror.org/040cn9093Community Health Network Inc, United States.

The Journal of law, medicine & ethics : a journal of the American Society of Law, Medicine & Ethics
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PubMed
Resumen
Este resumen es generado por máquina.

Las directivas anticipadas (DA) para dejar de comer y beber voluntariamente (VSED) en pacientes con demencia son complejas. La alimentación mínima de confort ofrece un enfoque más ético y práctico, equilibrando los intereses del paciente y reduciendo la angustia del cuidador.

Palabras clave:
VSEDdirectiva anticipadademencia avanzadademenciadejar de comer y beber voluntariamente

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Área de la Ciencia:

  • Ética Médica
  • Medicina Geriátrica
  • Cuidados Paliativos

Sus antecedentes:

  • Las directivas anticipadas (DA) son documentos legales que describen los deseos del paciente para el cuidado al final de la vida.
  • Dejar de comer y beber voluntariamente (VSED) presenta desafíos éticos, legales y prácticos únicos, especialmente en la demencia avanzada.
  • Las DA de VSED existentes tienen deficiencias para abordar estas complejidades.

Objetivo del estudio:

  • Evaluar críticamente las complejidades éticas, legales y prácticas de las DA de VSED en la demencia avanzada.
  • Evaluar una nueva DA de VSED propuesta para superar las limitaciones existentes.
  • Proponer un marco ético y una estrategia alternativos para el cuidado al final de la vida en la demencia avanzada.

Principales métodos:

  • Revisión de la literatura existente y marcos éticos sobre VSED y DA.
  • Análisis de una novedosa DA de VSED propuesta por Pope y colegas.
  • Comentario y argumentación ética sobre la justificación y la implementación de las DA de VSED.

Principales resultados:

  • Las DA actuales de VSED tienen limitaciones éticas y prácticas significativas.
  • Una nueva DA de VSED puede no resolver completamente el dilema ético de honrar los deseos de VSED en medio de la angustia del paciente.
  • La justificación ética para honrar las DA de VSED cuando los pacientes muestran angustia y sufrimiento sigue siendo insuficiente.
  • La angustia moral de los cuidadores puede surgir al honrar las DA de VSED en tales circunstancias.

Conclusiones:

  • Se presenta la alimentación mínima de confort como una alternativa más éticamente sólida y práctica a VSED en la demencia avanzada.
  • Este enfoque equilibra mejor los intereses inmediatos y a largo plazo del paciente.
  • Abordar las complejidades éticas y la angustia moral de los cuidadores es crucial para estrategias efectivas de cuidado al final de la vida.