Pravne in etične dileme v paliativni oskrbi

(magistrsko delo)

Tanja Hovnik Markota (Author), Suzana Kraljić (Mentor), Jadranka Stričević (Co-mentor)

Abstract

Izhodišča: Odločanja v paliativni oskrbi ne sprožajo zgolj burnih medijskih reakcij, ampak so tudi nenehen vir pravnih in etičnih dilem zdravstvenega osebja, ki jo izvaja. Etična priporočila za odločanje o zdravljenju in paliativni oskrbi bolnika ob koncu življenja v intenzivni medicini so dobra podlaga za delovanje. Pravna ureditev področja paliativne oskrbe pa je v Sloveniji še vedno površna – ni sistemska, paliativna oskrba ni umeščena v ustrezne pravne dokumente. Namen: Ugotoviti, kakšna sta med zaposlenimi v zdravstveni negi poznavanje in raba zakonodaje in etičnih načel, ki se nanašajo na izvajanje paliativne oskrbe in kako ukrepajo ob prepoznavi etičnih in pravnih dilem pri delu s paliativnimi pacienti. Raziskovalna metodologija: Za pregled literature smo uporabili deskriptivno metodo. Raziskava temelji na kvantitativni metodologiji, instrument za pridobitev podatkov je bil strukturiran anketni vprašalnik z 22 vprašanji. Rezultati so bili statistično ovrednoteni s programoma Microsoft Excel in SPSS 20.0. Rezultati: Raziskava kaže, da približno polovica udeležencev pozna ukrepe v primeru soočenja s pravnimi in etičnimi dilemami (49,4 %). Glede na izide smo ovrgli tudi predpostavko, da stopnja izobrazbe zaposlenih v zdravstveni negi vpliva na ukrepanje ob pojavu pravnih in etičnih dilem. Anketirani si želijo sprememb in izpopolnitev pravic pacientov, obravnavanih v paliativni oskrbi (75,6 %), ugotavljajo, da je nujno potrebna tudi sprememba glede doslednosti pri udejanjanju teh pravic v klinični praksi (84,9 %). Nazadnje smo preverjali, ali prihaja do razlik v prepoznavanju etičnih dilem in ukrepanju v primeru le-teh, med zaposlenimi v zdravstveni negi na internističnih in kirurških oddelkih Splošne bolnišnice Slovenj Gradec. Razhajanja so deloma prisotna. Diskusija in zaključek: Raziskava, ki smo jo izvedli, potrjuje in znova opominja na dejstvo, da je paliativna oskrba v Sloveniji pravno še vedno preskopo obravnavana. Kaže se tudi, da so zaposleni v zdravstveni negi nezadostno izobraženi in usposobljeni za izvajanje paliativne oskrbe. Pravne in etične dileme, ki se posledično pojavljajo, predstavljajo veliko breme izvajalcev paliativne oskrbe, škodo pa posledično trpijo pacienti in njihovi svojci.

Keywords

paliativna oskrba;zakonodaja;pravice pacientov;etična priporočila;zdravstvena nega;

Data

Language:	Slovenian
Year of publishing:	2018
Typology:	2.09 - Master's Thesis
Organization:	UM PF - Faculty of Law
Publisher:	[T. Hovnik Markota]
UDC:	616-036.8-083:34(043.2)
COBISS:	2443684
Views:	1988
Downloads:	552
Average score:	0 (0 votes)
Metadata:

Other data

Secondary language:	English
Secondary title:	Legal and ethical dilemmas in palliative care
Secondary abstract:	Introduction: Decision-making in palliative care does not only trigger vigorous media reactions, but also presents a constant source of legal and ethical dilemmas of healthcare professionals who implement palliative care. Ethical recommendations for decision-making on treatment and palliative care of patients at the end of life in intensive care medicine are a good ethical basis for work in the palliative care. But the legal regulation of the field is still not systemic; the palliative care is not placed in the relevant legal documents. The purpose of our research was to evaluate the level of knowledge of ethical and legal provisions of the health care providers and how do they act when recognizing ethical and legal dilemmas in dealing with palliative patients. Methods: The survey was based on a quantitative methodology, while the data acquisition instrument was a structured questionnaire containing 22 questions. The results were statistically evaluated using Microsoft Excel and SPSS 20.0. A descriptive method was used for the literature review. Results: The survey shows that about half of the participants are aware of the measures in case of facing legal and ethical dilemmas (49.4%). According to the results, we refute the hypothesis which says that a level of education of the employees in health care influences actions in case of legal and ethical dilemmas in palliative care. Furthermore, we find that the respondents want to change and improve the rights of patients treated in palliative care (75.6%) and it also appears that in their opinion, there is an urgent need for a change in the implementation of those rights in clinical practice (84.9%). Finally, we examined whether there are differences in recognizing ethical dilemmas and taking action among health care workers at the internal and surgical departments of the Splošna bolnišnica Slovenj Gradec. The divergences are partially present. Discussion: The research confirms and reiterates the fact that palliative care in Slovenia is still legally underdeveloped. It also appears that nursing staff is under-educated and undertrained to perform palliative care. The legal and ethical dilemmas that subsequently arise are majorly burdensome for the palliative care providers and consequently they also cause great damage to the palliative patients and their relatives.
Secondary keywords:	palliative care;legislation;patient rights;ethical recommendations;health care;Palliative care;Ethics;Paliativna oskrba;Etika;Legislation;
URN:	URN:SI:UM:
Type (COBISS):	Master's thesis/paper
Thesis comment:	Univ. v Mariboru, Fak. za zdravstvene vede
Pages:	VIII, 71 f., 7 f. pril.
ID:	10949873