scholarly journals Ευθανασία: Ηθικά διλήμματα πολιτισμικής αυτοσυνειδησίας

Bioethica ◽  
2017 ◽  
Vol 3 (2) ◽  
pp. 81
Author(s):  
Κωνσταντίνος Κορναράκης (Konstantinos Kornarakis)
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Personal Experience ◽  
Fear Of Death ◽  
Patient’S Autonomy ◽  
Theological Thinking

This paper focuses on the anthropological background of Euthanasia’s cultural profile, claiming that a cultural reception of Euthanasia should previously deal with anthropological questions such as patient’s autonomy and its relation to existential freedom, the fear of death, the meaning of personal experience of pain in shaping one’s own freedom and the cardinal importance of community’s role in patient’s palliative care. The theological thinking can contribute in this interscientific dialogue on the end of life, re-opening the question of the ontology of person and consequently the question of eschatology.

scholarly journals Management of Hypoglycemia in Nondiabetic Palliative Care Patients: A Prognosis-Based Approach

2016 ◽  
Vol 10 ◽  
pp. PCRT.S38956
Author(s):  
Victor C. Kok ◽  
Ping-Hsueh Lee
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Terminal Illness ◽  
Physical Symptoms ◽  
Autonomic Response ◽  
Hypoglycemic Episode ◽  
Family Expectations ◽  
Existential Suffering ◽  
Hypoglycemic Attack ◽  
Patient’S Autonomy

Hypoglycemia due to underlying terminal illness in nondiabetic end-of-life patients receiving palliative care has not been fully studied. For example, we do not have adequate information on the frequency of spontaneous hypoglycemia in patients as occurs during the different stages of palliative care. Depending on the case-mix nature of the palliative care ward, at least 2% of palliative care patients may develop hypoglycemia near the end of life when the remaining life expectancy counts down in days. As many as 25%–60% of these patients will neither have autonomic response nor have neuroglycopenic symptoms during a hypoglycemic episode. Although it is not difficult to diagnose and confirm a true hypoglycemia when it is suspected clinically, an episode of hypoglycemic attack may go unnoticed in some patients in a hospice setting. Current trends in palliative care focus on providing treatments based on a prognosis-based framework, involving shared decision-making between the patient and caregivers, after considering the prognosis, professional recommendations, patient's autonomy, family expectations, and the current methods for treating the patient's physical symptoms and existential suffering. This paper provides professional care teams with both moral and literature support for providing care to nondiabetic patients presenting with hypoglycemia.

scholarly journals End-of-life dreams and visions as perceived by palliative care professionals: A qualitative study

2021 ◽  
pp. 1-6
Author(s):  
Stina Nyblom ◽  
Ulla Molander ◽  
Inger Benkel
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Qualitative Content Analysis ◽  
Nordic Country ◽  
Fear Of Death ◽  
Focus Group Interviews ◽  
Inner Experiences ◽  
Dreams And Visions ◽  
Sound Mind ◽  
Group Interviews

Abstract Objective End-of-life dreams and visions (ELDVs) have been suggested to be prevalent psychic phenomena near death that can provide meaning and comfort for the dying. There is a lack of studies from the secular Nordic countries. The aim of this study was to determine whether palliative care professionals in a Nordic country have experience of patients expressing dreams, visions, and/or inner experiences and, if so, how they are perceived. Method Focus-group interviews with 18 professionals in end-of-life palliative care were subjected to qualitative content analysis. Results Most (15/18) professionals had experience of patients with ELDVs. A dominant content was deceased loved ones. According to most professionals, many patients perceived their ELDVs as real and could report them with clarity. The experience could result in peacefulness for patients, as well as loved ones, and reduce fear of death. Some professionals themselves perceived ELDVs to be real and a normal part of dying while a few found them scary. Most professionals, however, found ELDVs hard to grasp. Many tried to explain the phenomena as the result of medical circumstances and confusion, although reporting that they considered most patients to be normal and of sound mind in connection with their reports on ELDVs. Most patients wanted to talk about their ELDVs, but some could be reluctant due to fear of being considered crazy. The professionals were open-minded and reported having no problem talking about it with the patients and tried to normalize the experience thereby calming the patient and loved ones. Significance of results The results strengthen the suggestion that ELDVs are common phenomena near death, worldwide. Although most professionals in palliative care recognized ELDVs as beneficial to patients, many found the phenomena hard to grasp and sometimes difficult to distinguish from confusion, indicating a continuous need for exploration and education.

scholarly journals Tua o te Aria. Doorways into Dying

2018 ◽  
Vol 22 (1) ◽  
pp. 37-47
Author(s):  
Kay Ryan
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Personal Experience ◽  
Growth And Development ◽  
Family Members ◽  
Terminally Ill ◽  
States Of Consciousness ◽  
The World ◽  
Process Oriented ◽  
Process Disturbances

As we age or become terminally ill, we are confronted by our mortality. Being confronted by our own or another’s death can be a time of accelerated and profound growth and development. Using examples from research and personal experience working in a hospice, this article explores challenges facing our own dying as well as that of clients and family members. It discusses the relevance and benefits of psychotherapy at end of life. Throughout the dying process, disturbances can occur that may be dismissed or pathologized. This article goes further and suggests that the dying person’s apparent confusion, complex language, agitation or unusual movements, dreams and visions are some of the ways they communicate their needs and let us know what is happening to them. These phenomena are doorways through which we can connect and assist the dying to find meaning in what is happening. The dying may also experience altered and extreme states of consciousness such as coma. It is believed that in these deep inner states they are continuing their development and making spiritual connections. Rather than leaving them alone to fend for themselves, innovative interventions such as joining the world of the patient and pacing their breath are suggested. The work described in this article is based on the methods and skills found in Process Oriented Psychology, and its application to palliative care. Whakarāpopotonga Ka koroheke haere ake tātau, ka whakahemohemo ana rānei, ka putēhia mai tātau e mate. Putēhia mai ana e tō tātau, tō tētahi atu mate rānei, te wā whakatere whakaaroarohanga pakeketanga whanaketanga. Mai i ngā tauira rangahau, ngā wheako whaiaro mahi i te whare whakahemohemo, ka tūhurahia e tēnei tuhinga ngā whakatumatuma hāngai ki tō tatau, tō ngā kiritaki me ō te whānau. Ka matapakihia te whaitake me ngā hua o te whakaora hinengaro i te mutunga o te koiora. I te wā e whakamatemate ana tērā pea ka puta ake he ngākau kāhuirangi, a, e kene pea ka parea ki rahaki ka whakaaramātaihia rānei. He tirohanga atu anō tā tō tēnei tuhinga, e kī ana ko te ngākau kāhuirangi o te tūroro, te reo matatini, te kōmingomingotanga, oi rānei, ngā moemoeā ngā matakitenga ētahi o ngā momo whakaaturanga i ō rātau hiahia whakamōhio hoki e ahahia ana rātau. He kuaha ēnei pāmamaetanga e taea ai te hono atu, te āwhina atu i te hunga mate ki te rapu māramatanga mō ēnei pānga. Tērā pea ka wheakohia he takotoranga rērerekē, takotoranga tōpitopito o te mauri pērā i te maurimoe. E whakaponohia ana i roto i te ēnei takotoranga houroto e whakanake haere tonu ana rātau, ā, e hono atu ana ki te taha wairua. E meahia ana kaua rātau e waiho mokemokehia ki ā rātau anō, engari me huri ki te kōmuhu hou pēnei i te hono atu ki te ao o te tūroro ka whetoko i ō rātau hā. Ko te tūāpapa o ngā mahi whakaahuahia i roto I tēnei tuhinga nō ngā tukanga me ngā pūkenga kai roto i Tukanga Pānga Hinengaro, me ana whakatau ki te mahi haumanu.

Much Ado About Fried Chicken: Abetting Aspiration or Respecting Autonomy?

2019 ◽  
Vol 28 (3) ◽  
pp. 1356-1362
Author(s):  
Laurence Tan Lean Chin ◽  
Yu Jun Lim ◽  
Wan Ling Choo
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Multidisciplinary Team ◽  
Biopsychosocial Model ◽  
Family Members ◽  
Clinical Decisions ◽  
Goals Of Care ◽  
Complex Needs ◽  
Aspiration Risk ◽  
Patient Centric

Purpose Palliative care is a philosophy of care that encompasses holistic, patient-centric care involving patients and their family members and loved ones. Palliative care patients often have complex needs. A common challenge in managing patients near their end of life is the complexity of navigating clinical decisions and finding achievable and realistic goals of care that are in line with the values and wishes of patients. This often results in differing opinions and conflicts within the multidisciplinary team. Conclusion This article describes a tool derived from the biopsychosocial model and the 4-quadrant ethical model. The authors describe the use of this tool in managing a patient who wishes to have fried chicken despite aspiration risk and how this tool was used to encourage discussions and reduce conflict and distress within the multidisciplinary team.

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