In order to respect the patient’s right to die at home, with quality and respect, discussions about bioethical problems involving palliative care in the context of primary health care are relevant. Among bioethical problems, communication problems regarding the diagnosis and treatment, the maintenance or discontinuation of futile treatments, the adoption of aggressive and lifelong measures by the emergency mobile service, and the problems involving equal access to care stand out. It is important to emphasize that health systems must incorporate palliative measures in primary care and enable professionals to provide this type of care.
Part of the book: Reflections on Bioethics
Advance directives (ADs) are understood as the act of deciding what care the patient wants to receive in the period before death. Preserving the patient’s autonomy by choosing his care guarantees human dignity during the process of dying. In Brazil, life expectancy and supportive technologies have increased, leading to growth of the number of terminally ill patients. However, there is still no legislation regulating ADs causing legal uncertainty in health professionals. Nursing professionals have the support of the Federal Nursing Council to respect the ADs, but, because it is an issue little explored, nursing professionals do not feel safe in the use of ADs, and changes in the curricula of the undergraduate courses in nursing are extremely needed, ensuring that patients have their wishes met during the dying process. Thus, this chapter deals with bioethical and legal issues involving ADs and nursing in the Brazilian context, proposing to deepen reflection and criticism on the issue and subsidies for decision-making.
Part of the book: Neuroethics in Principle and Praxis