Abandonment or Humanization? A medical reflection on palliative care

This article was exclusively written for The European Sting by Ms. Aryane Bastos de Souza, a student of the fourth period of Medicine of the State University of Rio Grande do Norte-UERN, Brazil. She is affiliated to the International Federation of Medical Students Associations (IFMSA), cordial partner of The Sting. The opinions expressed in this piece belong strictly to the writer and do not necessarily reflect IFMSA’s view on the topic, nor The European Sting’s one.

Faced with waiting for death, at the moment when it is realized that medical and technological resources are impossible to maintain a dignified life, a feeling of helplessness on the part of many health professionals arises. In this context, the decision to proceed with invasive and exhaustive methods is opposed to the choice to provide more pleasant and pleasant days for the user and their companions.

  Concomitantly, the dilemma about prolonging life at any cost and allowing the brief arrival of death, leads to reflection on the role of palliative care. Given this situation, it is essential to have a medical view on what it means to refer a patient to palliative care.

  In this context, many professionals, and even family members, understand it as a patient’s abandonment, as if the discarded procedures were harmful to the client. However, this line of care offers the individual that their last days have a higher quality of life. Furthermore, despite the fact that, supposedly, it allows the abbreviation of life, palliative care seeks to alleviate pain and bring comfort to the patient and family in this very delicate moment, in the face of an incurable disease.

  In addition, to corroborate this premise, the constitution of the World Health Organization (OMS/WHO) states: “Health is a state of complete physical, mental and social well-being and not just the mere absence of disease or infirmity”. Thus, the palliative care network has the role of guaranteeing this concept of health for those who are terminally ill or when curative treatment is no longer achieving the expected healing effect.

  From that time on, palliative care humanizes this care for the patient, from diagnosis to the terminal state, seeking to relieve pain and bring comfort. In addition, it helps the individual with no expectation of a cure to remain as active as possible until the end of his life.

  According to this reflection, health professionals must provide assistance with respect to truth and honesty in all matters involving patients, family members and other professionals. Furthermore, seek clear and objective communication, but sensitive and empathetic to the user and their caregivers. With the exception that, they are experiencing a difficult and painful process of understanding and accepting death.

  Based on this premise, therefore, the concept reported by OMS/WHO (2002) will materialize, in which palliative care is the approach that promotes quality of life for patients and their families in the face of diseases that threaten the continuity of life, through prevention and relief of suffering. And, it requires early identification, assessment and impeccable treatment of pain and other problems of a physical, psychosocial and spiritual nature.

References

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GOMES, ANA LUISA ZANIBONI; OTHERO, MARÍLIA BENSE. Cuidados paliativos. Estud. av.,  São Paulo ,  v. 30, n. 88, p. 155-166,  Dec.  2016 .   Available from http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0103-40142016000300155&lng=en&nrm=iso. Access on  20  Dec.  2020.  http://dx.doi.org/10.1590/s0103-40142016.30880011.

Manual de Cuidados Paliativos/Academia Nacional de Cuidados Paliativos – Rio de Janeiro: Diagraphic, 2009. 320 p. – ANCP.

OMS – ORGANIZAÇÃO MUNDIAL DE SAÚDE. Declaração de Alma-Ata: primeira conferência internacional sobre cuidados primários de saúde. Genebra, 1978.

About the author

Aryane Bastos de Souza is a student of the fourth period of Medicine of the State University of Rio Grande do Norte-UERN. She is a Local Coordinator at the International Federation of Medical Students’ Associations (IFMSA). Participant in the ECAH extension project (Teaching Children Aspects of Hygiene). Participant of the Collective Health Study Group. Research Coordinator at LAPED (Pediatric Academic League). Secretary and Director of Communication of LATOCE (Academic League of Operative Technique and Experimental Surgery).

She believes that education and humanization are capable of transforming public health and alleviating inequalities.