Ethical dilemmas in infaustic prognoses: an empiric study

Česká verzia

Authors: Jaromír Škoda ^1,2; Kateřina Ivanová ¹
Authors place of work: Ústav veřejného zdravotnictví LF UP, Olomouc ¹; Ústav lékařské etiky a humanitních základů medicíny 2. LF UK, Praha ²
Published in the journal: Geriatrie a Gerontologie 2021, 10, č. 4: 210-215
Category: Original Article

Summary

The essay deals with the dilemmas of terminally ill patients aged 60 years or older. The sampling consists of 507 case studies and was assessed according to the interpretative phenomenological analysis (IPA). Our assumption for the evaluation results from a combination of the bioethical principialism and the Four Boxes method. In terms of IPA, we do not assess the cases in a way that would unnecessarily contaminate the experiences of the practitioners. Practitioner vs. his surroundings was the interaction which was taken as the criterion for classification. We group the case studies based on who, according to the author (the practitioner), is an accomplice in the ethical conflict. We specify the types of the ethical conflicts of individual groupings in the following manner: practitioner vs. institution, practitioner vs. patient, practitioner vs. family, practitioner vs. practitioner. These clusters are satiated by 9 types of situations – we introduce them through by providing examples and statements. In summary, based on the experiences of practitioners, we could claim that certain ethical dilemmas, which can be assumed intuitively in the case of the terminally ill, are evident: dilemmas concerning treatment and conflicts with the patient, with his family, and, in exceptional cases, with another practitioner. We regard conflicts related to disputes between the practitioner and the institution as of utmost importance. This grouping is predominantly concerned with the following question: When does palliative care turn into keeping the patient forcefully alive regardless of the patient’s increasing suffering.

Keywords:

Bioethics – ethical dilemma – infaust – terminal – experience of physicians – persons 60+

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