The terminality of life and the role of health professionals and their respective palliative care protocols

: Hospice & Palliative Medicine International Journal
: Délio Tiago Martins Malaquias,¹ Daniella Campos Furtado,¹ Aline Cristina Couto da Silva,¹ Fernanda Lino Botteon,¹ Kianny Sanches da Silva,¹ Roselene de O. Carvalho,¹ Diógenes Trabuco da Silva Oliveira,¹ Júlio Elias Calheiros,¹ Ivanir José Cordeiro Moreira Junior,¹ Giovana Rocha Victorello,¹ Aline de Oliveira Mota,¹Thayane Gonçalves da Silva Marques,¹ Pedro Lucas Vieira Valença,¹ Juliana Fontes Beltran Paschoal,^1,2 Rafael Pinheiro do Nascimento,³Giovana Casarini Yamashiro,³ Karen Miyamoto Moriya,³ Andreza Spinola Zaparoli,³ Maria Eduarda Pellegrina Vieira,³ Liliana Martins Occulate,⁴ Cristiano Bento Alvarenga,⁴ José Antônio do Nascimento Neto,⁴ Suely Fernandes dos Santos,⁶ Roger Pereira Novóa,⁷ Hamilton Roberto Moreira de Oliveira Carriço,⁸ Giuliana Pagliace,⁹ Thiago Augusto Rochetti Bezerra^1–9

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Abstract

Introduction: Palliative care is an approach that improves the quality of life of patients

and their families in the face of life-threatening illnesses, relieving suffering and treating

pain and other physical, psychosocial and spiritual symptoms. In order to minimize pain

and suffering in this dying process, it has become necessary to implement palliative care

protocols in ICUs. Objectives: The aim of this study was to carry out an up-to-date literature

review on the terminality of life and the role of health professionals and their respective

palliative care protocols.

Material and methods: The methodology used was a literature review. Results: The

importance of treating a terminally ill patient was noted, many of the curative/restorative

measures may constitute futile treatment, such as parenteral or enteral nutrition,

administration of vasoactive drugs, renal replacement therapy, institution or maintenance of

invasive mechanical ventilation and even hospitalization or permanence of the patient in the

ICU. Conclusions: Through a review of the literature, this study found that the provision

of palliative care to seriously ill patients and their families must follow the wishes of the

patient themselves, their relatives and the multi-professional team. With regard to the

patient’s own wishes, the autonomy of the individual and the principle of non-maleficence

must be respected, prioritizing decisions by consensus within the maximum certainty of

irreversibility. Thus, the team’s decision must be preceded by the consent of the patient or

their legal representatives, recorded in the medical records.

palliative care; ICU palliative care protocols; relief of suffering, pain management