Authors

1Manuel Fernando Guardia Mesa, 2Ángel Cobos Vargas, 1Montserrat Montes Vega, 1Carolina Padial Fregenal

Position

¹Enfermero/a de Cuidados Intensivos del Hospital Universitario Virgen de las Nieves de Granada. Servicio Andaluz de Salud.²Enfermero de Cuidados Intensivos del Hospital Universitario San Cecilio de Granada. Servicio Andaluz de Salud.  

Contact address

Manuel Fernando Guardia Mesa. C/ Abeto, 5. Urbanización Huerta del Pilar. Belicena (Vegas del Genil). 18193 Granada.

Contact email: mfguardia@yahoo.es

Abstract

Objective: to explore the opinion of the Nursing staff in the Intensive Care Unit of a clinical-surgical hospital about the limitation of therapeutic effort.
Method: prospective descriptive study, conducted during October and November, 2013, through a validated self-completion questionnaire. The study population was the Nursing assistants and professionals from the Intensive Care Unit of the Hospital Universitario Virgen de las Nieves, Granada. The inclusion criteria were experience over two years in said Unit. Socio-demographical and qualitative variables were analyzed, and potential statistical associations were studied with Chi-square Test.
Results: out of those 88 persons analyzed, 58 nurses and 30 assistants, a 72.4% thinks that not initiating is not the same as withdrawing treatment already initiated, vs. 27.6% who think that it is the same. Regarding who must make the decision to apply extraordinary support measures in incurable conditions, 77% assigns higher weight to patients’ decision. A 57% have made public their wish not to receive them if they were in a critical or end-stage situation. Regarding the legalization of euthanasia, 71.8% are in favour, and 81.4% would apply it in incurable patients or dying situations, if previously expressed. A 98.9% are in favour of orthothanasia.
Conclusions: the importance of the existence of an Advance
Directive Registry must be pointed out; the use of said registry should be encouraged in order to prevent a conflict of interests, through a clear awareness of the patient’s opinion. When this
document is not available, in case of conflict, and provided patients are not able to decide on their own, the intervention of the Healthcare Ethics Committee appears as the most adequate solution.

Keywords:

Limitation of Therapeutic Effort; euthanasia; orthothanasia; intensive care; end-stage situation; Advanced Directives; Bioethics

Versión en Español

Título:

Limitación del esfuerzo terapéutico en cuidados intensivos