El autor comienza con una breve reseña de su propio involucramiento en la (-uestión, centrándose en la reunión defilósofos morales, teólogos, doctores, abogados y enfermeras que él presidió en 1986 para discutir este tema en prnfÚndidad, después de que la declaración de 1985 de la Pontificia Academia de Ciencias dijo que no se requiere el tratamiento de la persona permanentemente inconsciente, aunque si se les Jebe todo el cuidado, incluyendo la alimentación. Este encuentro lo llevó a él y a otros (...) a cambiar sus posturas iniciales, las cuales consideraban que la alimentación no era obligatoria, y a preparar un escrito, publicado en Temas de la ley y Medicina, en 1987, y .firmado por más de 90 estudiosos, aportando las razones por las cuales se requiere moralmente la alimentación. Después, el autor revisa las posturas desde diferentes fuentes, incluyendo a obispos católicos y estudiosos, desde los primeros años ochenta hasta la declaración de Juan Pablo II del 20 de marzo de 2004. En particular, presenta el argumento que ha tenido mucha influencia presentado por Kevin O 'Rourke, OP, sosteniendo que una lectura adecuada del escrito de 1957. (shrink)

Background: Since the passage of the Patient Self-Determination Act, numerous policy mandates and institutional measures have been implemented. It is unknown to what extent those measures have affected end-of-life care, particularly with regard to the do-not-resuscitate order.Methods: Retrospective cohort study to assess associations of the frequency and timing of DNR orders with advance directive status, patient demographics, physician’s specialty and extent of documentation of discussion on end-of-life care.Results: DNR orders were more frequent for patients on a medical service than on (...) a surgical service and were made earlier in the hospital stay for medicine than for surgical patients . 22.18% of all patients had some form of an advance directive in their chart, yet this variable had no impact on the frequency or timing of DNR ordering. Documentation of DNR discussion was significantly associated with the frequency of DNR orders and the time from DNR to death .Conclusions: The physician’s specialty continues to have a significant impact on the frequency and timing of DNR orders, while advance directive status still has no measurable impact. Additionally, documentation of end-of-life discussions is significantly associated with varying DNR ordering rates and timing. (shrink)

There are numerous and varied pathologies that can lead to a state of terminal illness, provoking numerous bioethical dilemmas that are inherent and specific to each circumstance. The objective of the present work has been to provide a current and useful analysis that can help to understand the main bioethical problems, from the perspective of biolaw that must be solved in the inevitable path towards the end of life that any terminal illness implies. The methodology used included a study of (...) bibliographic documentation in the main databases of interest in bioethics. It can be concluded that the biolaw is a very useful tool that helps health care professionals and relatives when it comes to the analysis and decision making regarding a terminal illness. Independently of medical practice based on protocols and scientific knowledge, it is necessary to ensure that not everything that can legally be carried out is accepted in the field of biolaw. (shrink)