Abstract

LILIANA GIL, Beatriz. COPD in the Final Stage of Life: Procedure Recommendations. Rev. amer. med. respiratoria [online]. 2012, vol.12, n.2, pp.54-61. ISSN 1852-236X.

Chronic Obstructive Pulmonary Disease (COPD) is a progressive disease that can reach terminal stages, in which medical decisions should be taken with the patient' s participation. A major difficulty is the lack of a clear definition of "terminal stage of COPD". Frequently doctors fail explaining patients about the disease evolution and at critical situations patients are hospitalized at intensive care units. The main objective of this paper is to consider theoretically different clinical criteria and indicators to identify COPD patients who are at the end of life and estimate survival expectancy; thus opportune palliative measures can be prescribed, that have been accepted by the patient in an Anticipated Decision Plan. The progressive, honest, adequate information about the disease and its prognosis, together with an empathic communication between the doctor, the patient and the family will prevent fear of death and abandon. The patient should be assured that the doctor with take care of him always, especially at the end of life and will respect the anticipated instructions based on his wishes and values. The doctor should follow the Bioethics Principles and sometimes should consult the Hospital Ethical Committee.

Keywords : Bioethics principles; End of life in COPD; Clinical criteria and indicators about end of life; Palliative care and end of life care; Proportionate or disproportionate measures; Advanced directives.

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