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Copyright of Medicina (Buenos Aires) is the property of Medicina (Buenos Aires) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Resumen Objetivo: Explorar los conocimientos y actitudes de los profesionales sanitarios con relación a las voluntades previas en dos regiones de España: Cantabria e Islas Baleares. Metodología: Estudio descriptivo transversal mediante cuestionario autoadministrado online. Se analizaron variables sociodemográficas, conocimientos y actitudes relacionados con las voluntades previas. El estudio se aprobó por el Comité Ético de Investigación Clínica de Cantabria. Resultados: Respondieron al cuestionario 274 profesionales sanitarios, de Cantabria 222 y de Islas Baleares 52. Un 75,6% respondió que otorgaría documento de voluntades previas y un 86,6% que lo recomendarían a sus pacientes crónicos. Un 15,5% expresó sentirse preparado para informar, un 95,2% que desearía recibir formación. Las enfermeras tuvieron más conocimientos concretos que otros profesionales con relación al procedimiento, validez y consulta del documento. Cantabria y Baleares presentaron diferencias estadísticamente significativas en intención de otorgar (p = 0,005) y en haber consultado o propuesto consultar el Registro de Voluntades Previas durante la práctica profesional (p = 0,000), en ambos casos con mayor porcentaje en Cantabria. Conclusiones: La percepción de los profesionales acerca de sus conocimientos relacionados con las voluntades previas es escasa, y su actitud es de respeto a estas, y las consideran útiles para todos los implicados. Su especial relevancia en la población de mayor edad constituye a las enfermeras especialistas en enfermería geriátrica-gerontológica principales beneficiarias e impulsoras de las voluntades previas.

Objetivos: Describir la forma en que se establecen normativamente el consentimiento informado (CI) y las directivas anticipadas (DA) en países latinoamericanos en relación a la asistencia en salud y la investigación, y su análisis desde la bioética. Métodos: Se realizó un análisis comparativo de las normativas vigentes de los 21 países latinoamericanos respecto al CI y las DA. Se confeccionaron reportes de extracción de datos que fueron diseñados antes de iniciar el proceso de investigación para cada país. Se analizaron cualitativamente similitudes y diferencias respecto a variables predefinidas. Se realizaron tablas para sintetizar la información donde fue posible. Resultados: Dieciocho países latinoamericanos prevén una norma específica para el uso del CI en el ámbito clínico. Seis países han incorporado normativas respecto al uso del CI en la virtualidad. Respecto al uso del CI en investigación, 20 países latinoamericanos prevén una norma específica para este ámbito. En el caso de la exposición académica, son 6 países los que nombran esta situación en la normativa. Siete países latinoamericanos cuentan con normativa para establecer DA. Conclusiones: América Latina ha presentado una notable evolución en torno a normar dos de los más importantes instrumentos del ejercicio de la autonomía, como los son el CI y las DA. La legislación sobre ambos instrumentos no garantiza mayor autonomía en salud, pero su existencia como reguladora de acciones para la toma de decisiones constituye el primer paso para su ejercicio.

Copyright of Revista Bioetica is the property of Conselho Federal de Medicina and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Gerokomos is the property of Indemm Farma SL and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Bioetica is the property of Conselho Federal de Medicina and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Eletrônica de Enfermagem is the property of Revista Eletronica de Enfermagem and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Bioetica is the property of Conselho Federal de Medicina and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Bioetica is the property of Conselho Federal de Medicina and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Bioetica is the property of Conselho Federal de Medicina and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Universitas Médica is the property of Pontificia Universidad Javeriana and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Bioetica is the property of Conselho Federal de Medicina and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Bioetica is the property of Conselho Federal de Medicina and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introducción: La ley número 18473 de voluntades anticipadas fue promulgada en Uruguay en el año 2009, reglamentándose cuatro años después. Esto evidencia una propensión hacia la autonomía y la planificación del futuro de los enfermos. Objetivo: Determinar el conocimiento por parte de los profesionales de la salud en cuanto a la ley, su empleo en la clínica y acceso al formulario de voluntades anticipadas. Método: Investigación descriptiva, mediante una encuesta anónima a médicos uruguayos generales y especialistas en actividad, enviada por redes sociales. Resultados: Se obtuvieron 363 respuestas, con un 97 % de profesionales que atendían enfermos, un 79,5 % no habían extendido el documento y más del 50 % no tenía conocimiento de la ley. Conclusión: El conocimiento sobre las voluntades anticipadas en el cuerpo médico uruguayo es escaso y es aún más su aplicación a los pacientes.

La Ley Nº 18.473 y el Decreto que la reglamenta (385/013) fueron concebidos con la finalidad de dar un marco normativo a la posibilidad que tiene una persona de establecer sus preferencias sobre ciertos actos médicos cuando todavía es capaz de consentir, ejerciendo su autonomía de manera anticipada ante la eventual pérdida de capacidad de decisión. Por lo tanto, el hecho de llevar a cabo o no un procedimiento médico no dependerá de la capacidad de consentir de la persona en ese momento, esto es lo que la diferencia del consentimiento informado habitual.

Copyright of Revista Bioetica is the property of Conselho Federal de Medicina and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Las Voluntades Anticipadas son una forma de defensa de la autonomía y dignidad de los usuarios en el final de la vida. En Chile, no existen leyes que la validen, por lo cual los enfermeros toman especial relevancia por ser quienes otorgan cuidados en todo el ciclo vital. Objetivo: Conocer la percepción de los profesionales de enfermería de una Unidad de Paciente Crítico sobre su rol en la voluntad anticipada en el final de la vida. Metodología: Estudio cualitativo, paradigma post positivista con enfoque de estudio de caso. Realizado entre Octubre y Noviembre del 2017. Se logró la saturación teórica mediante la realización de 6 entrevistas de tipo semiestructuradas. Se utilizó análisis de contenido. Resultados: Ningún profesional de enfermería manejaba el concepto, sin embargo, varios lograban identificar elementos vinculados a la temática. Además, se identificó un escaso abordaje del tema durante la formación de pre y postgrado y la necesidad sentida de ampliar los conocimientos. Algunos asociaron el rol con la educación y apoyo, otros no lograron identificar la vinculación. Se evidenciaron algunas prácticas que apuntan a respetar las voluntades de las personas, con diversas disyuntivas en el proceso. Conclusión: Falta un largo camino por recorrer en cuanto al respeto de las preferencias de las personas al final de la vida, y para lograrlo es esencial el aumentar el conocimiento que poseen los enfermos sobre la temática. Posteriormente, es importante el establecer claramente su forma de aplicación y estrategias para facilitar el proceso, además de incorporarlo en el lenguaje cotidiano.

Copyright of Revista Bioetica is the property of Conselho Federal de Medicina and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

La Convención Interamericana para la Protección de los Derechos Humanos de las Personas Mayores regula la obligación de los Estados parte de implementar un proceso para que la persona mayor pueda manifestar, de manera expresa, su voluntad anticipada y sus instrucciones respecto de las intervenciones en atención de la salud. Chile ha ratificado este instrumento. El presente trabajo analiza el estado de la institución desde una perspectiva comparada y considera la oportunidad de su regulación expresa en Chile.

Resumen Introducción: Los ingresantes a una carrera universitaria cuentan con representaciones acerca de la carrera elegida y de su futuro profesional. Objetivo: Identificar la representaciones de los aspirantes de la carrera de Medicina con respecto a la imagen del rol profesional. Metodología: Estudio observacional y transversal, a partir de una encuesta implementada a 1857 aspirantes. Análisis de los datos: ANOVA o Datos Categorizados, con un 95% de confianza. Resultados y Conclusiones: En la población se detectó una edad de 19,03±0,06 años, no inserta en el mercado laboral, una mayor frecuencia de padres con estudios universitarios. El área elegida para el desempeño del rol es la de “Especialidades Médicas”. Los estudiantes encuestados refirieron en cuanto a la imagen del rol profesional en primer lugar, las cualidades personales, la formación permanente y la responsabilidad. Predomina el deseo de ayudar y curar, a través de un rol profesional idóneo. En cuanto a los aspectos preventivos de la carrera como futuro profesional, el 48% enuncian el compromiso social y ayudar a la gente, reafirmando el aspecto social y solidario del Rol Profesional. El 50 % proyecta la idoneidad profesional y continuar con la formación permanente, enfatizando el aspecto cognitivo.

Copyright of Revista de Derecho Privado (0123-4366) is the property of Universidad Externado de Colombia, Departmento de Derecho Civil and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Bioetica is the property of Conselho Federal de Medicina and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Bioetica is the property of Conselho Federal de Medicina and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Sexualidad, Salud y Sociedad: Revista Latinoamericana is the property of Editora da Universidade do Estado do Rio de Janeiro (EdUERJ) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Gaucha de Enfermagem is the property of Revista Gaucha de Enfermagem and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Bioetica is the property of Conselho Federal de Medicina and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Bioetica is the property of Conselho Federal de Medicina and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Advance healthcare directives are intended for the individual to personally express their will and preferences about healthcare and treatment ahead of time. This literature review aims to describe the concept and structure of advance directives and the ethical aspects involved in patient care. Using the keywords "Advance Healthcare Directive" AND "Ethical Implication" and its Spanish equivalents (voluntades anticipadas, implicaciones éticas), five databases were accessed: ProQuest, Philosophy (JSTOR), PubMed, Web of Science and Scielo. Publications were narrowed down to the 2010-2018 period. Thirty-one articles were obtained and read critically. Results of this review were grouped into the following categories: concept, structure, clinical situations in which advance directives apply, strengths and limitations, as well as the ethical aspects involved. End of life-related experiences in which a person loses their ability to make decisions and cannot express their wishes, so it is impossible to know their will, are more common nowadays. Most health workers are not appropriately trained in the preparation and application of advance directives, which becomes an opportunity to research and delve deeper into the subject. Advance directives are a tool that gives health workers reliable information on a patient's values and wishes, so it is vital to train them to provide respectful quality care. [ABSTRACT FROM AUTHOR]

RESUMOObjetivo:caracterizar a produção científica nacional e internacional sobre as diretivas antecipadas de vontade aplicadas ao doente terminal.Método:a revisão integrativa, incluindo os artigos publicados no Portal Capes, SCIELO, LILACS, MEDLINE, Revista de Bioética e Bioethikos, a partir dos descritores: Diretivas antecipadas, Testamentos quanto à vida, Advance Directives, Living Will e Terminally Ill totalizando 44 artigos submetidos à análise de conteúdo.Resultados:emergiram três categorias: Estudantes e profi ssionais frente às diretivas antecipadas de vontade: percepções, opiniões e condutas; Receptividade dos pacientes às diretivas antecipadas de vontade; A família diante das diretivas antecipadas de vontade.Conclusão:evidenciou-se a relevância do tema como garantidor do respeito à dignidade e à autonomia do doente, bem como para a redução dos conflitos éticos enfrentados pelos familiares e profi ssionais da saúde frente aos cuidados em fi nal de vida.

Objective: To understand how doctors and family caregivers understand the applicability of the Advance Directives to end-of-life care. Method: qualitative, descriptive and exploratory research, conducted with seven doctors of a university hospital in southern Brazil and seven family caregivers of patients at the end-of-life, from October to December 2014, from semi-structured interviews, submitted to discursive textual analysis. Results: two categories emerged: Advance Directives: the right to personal autonomy and conflicts and dilemmas in the applicability of Advance Directives. Conclusion: The Advance Directives are related to the respect of personal autonomy, professional support and reduction of the anguish and suffering of family care in view of the decision-making processes that involve the end of life. However, it is a practice surrounded by fears and concerns about its applicability and compliance by the professional. [ABSTRACT FROM AUTHOR]

Copyright of Revista Bioetica is the property of Conselho Federal de Medicina and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Bioetica is the property of Conselho Federal de Medicina and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Bioetica is the property of Conselho Federal de Medicina and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Bioetica is the property of Conselho Federal de Medicina and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aim: to know the perception of the health professionals about the applicability of the anticipated directives of will in the neonatal and pediatric context. Method: qualitative, descriptive and exploratory study, developed in pediatric and neonatal pediatric hospitalization units - of a university hospital in southern Brazil. Participated 16 professionals of the nursing and medical team. The collections took place through a semistructured interview, from September to October, 2015. A discursive textual analysis was performed. Results: Evidenced aspects that hinder the applicability of the Directives, such as: denial of death attitudes, weak communication, understanding of death as an event of a punctual nature, post hierarchy and professional instrumentalization. As facilitators, such as professional (multi) interaction, bonding and support in spirituality. Final considerations: There is a misunderstanding and unease about death and all its personal significance, reflecting the difficulty of applying the Directives in this context. [ABSTRACT FROM AUTHOR]

Copyright of Revista Gaucha de Enfermagem is the property of Revista Gaucha de Enfermagem and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: The prolongation of the survival of the elderly and the progress in the treatment of chronic diseases has increased the prevalence of functionally dependent persons. The advancement of the therapeutic and therapeutic resources of medicine in the last decades has brought dysthanasia as a side effect. A relatively recent phenomenon in society has led to discussions of a clinical, bioethical and juridical nature, in order to solve dilemmas and modernize laws, adapting to this new reality. Objectives: To analyze the role of advance directives in the context of palliative care. Methodology: A narrative review was carried out investigating articles published in the Journal of Bioethics of the Federal Medical Council of Brazil and its last resolutions in the past ten years. To this end, current data was collected in the legal context, analyzing the legal support of the decision-making process by the geriatrician. Result: There were identified nine articles and three main resolutions. Conclusions: In Brazil, there is no specific legislation on the subject. Although the new Code of Medical Ethics represented a breakthrough, it was not enough to introduce this practice into the physician-patient relationship. Currently, the advance directives of Will are valid in light of the constitutional norms in force. [ABSTRACT FROM AUTHOR]

Objective: to understand how nurses understand the applicability of early intension directives in the care of the last phases of life. Methodology: qualitative, descriptive and exploratory research, carried out with eight nurses from a university hospital in the south of Brazil, in December 2014, based on semi-structured interviews, submitted to discursive textual analysis. Results: three categories emerged: conflicts in patient care in the final phase; Advantages and difficulties in the applicability of antecipated directives of intention; Benefits in the applicability of the antecipated intension directives by the nursing. Conclusion: The antecipated directives are related to the respect of personal autonomy, however a practice surrounded by fears and concern of its fulfillment. [ABSTRACT FROM AUTHOR]

En años recientes, las directivas anticipadas (DAs) han sido incorporadas de manera creciente en las sociedades latinoamericanas como un instrumento que permite a los pacientes especificar el modo en que desearían ser tratados en caso de que no sean competentes. El objetivo principal de estos instrumentos es, por lo tanto, incrementar el respeto por la autonomía de los pacientes. No obstante, es importante para ello conocer la experiencia que arrojaron las DAs en otros países, para poder diseñar así la mejor manera de implementarlas. Igualmente importante es identificar posibles facilitadores y barreras que pudiera ofrecer el contexto latinoamericano para llevar a cabo dicho proyecto. En este artículo se analiza la evolución de las DAs en los Estados Unidos, se concentra especialmente en las dificultades que surgieron a lo largo de este proceso, y que se deben fundamentalmente a un abordaje excesivamente individualista del proceso de toma de decisiones. En contraste con ello, se argumenta que el rol importante que desempeñan generalmente las familias, u otras personas cercanas al paciente, en las sociedades Latinoamericanas ofrece condiciones favorables para lograr un abordaje más relacional, capaz de superar los problemas del modelo individualista. Sin embargo, se argumenta también que se necesitan esfuerzos importantes para mejorar la calidad de la relación médico-paciente-familia. En particular, la superación de las acciones paternalistas todavía ejercidas por algunos médicos, frecuentemente en conjunto con los familiares, constituye una condición necesaria para la implementación de las DAs.

La presencia de pacientes con síntomas refractarios e intensas crisis emocionales en la fase final de la vida irrumpen en la actividad diaria de los profesionales sanitarios. Esta eventualidad puede convertirse en una experiencia desconcertante por la escasez de recursos y habilidades adquiridas durante el periodo de formación. La medicina y sus profesionales son inculpados de prolongar el proceso de agonía y no aliviar el sufrimiento y la angustia. La dificultad de atender al paciente moribundo reside en las demandas psicológicas que produce y los conflictos internos que genera. ¿Qué se necesitaríamos nosotros en esa situación?. Es imprescindible disponer de una guía de actuación que oriente nuestro proceso terapéutico defendiendo siempre el mejor interés de la persona. En el presente trabajo se hacen algunas reflexiones sobre la muerte, el énfasis en curar y cuidar, sobre las necesidades y carencias de las personas en la fase final de sus vidas, las directivas anticipadas, los síntomas refractarios y la sedación paliativa y en como saber actuar en situaciones donde las fronteras éticas y legales están poco definidas o en debate permanente.