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Voluntades Anticipadas vs. Instrucciones Previas o Testamento Vital en Atención Primaria de Salud

2008; Sociedad Castellano-Manchega de Medicina de Familia y Comunitaria; Volume: 2; Issue: 5 Linguagem: Inglês

10.4321/s1699-695x2008000300004

2386-8201

Francisco Ángora Mazuecos,

Ethics in medical practice

Early Wills vs. Previous Instructions or Living Wills in Primary CareHypothesis and objective.The legal system recognizes the fundamental rights of terminal patients or dying ones who can use a Declaration of Early Wills (DEW), that corresponds to a certifi ed planning of treatments which respects the system of personal values of the patient, who can decide to die with dignity.However, a free choice requires clinical information about the possible options available.Nowadays, the reason why few people use DEW is that most of the legally required conditions are not fulfi lled.The main objective here is to fi nd information about the prolongation of life, legal and moral right to die with dignity, limitation of therapeutic effort (LTE) and the possibility of using DEW in Castilla La Mancha.Design.Study of primary intervention using a consecutive sample of patients over 65, from a PC setting, using "an informative course that gives an introduction to the EW" and "a survey of knowledge and opinions about EW", before and after the course.Setting.Urban Health Centre of Ciudad Real.Main Variables.Socio-demographic variables (age, gender, house, cohabitation, main job before retirement).Knowledge about and impressions of EW and DEW, before and after the course.Main fi ndings.The vast majority live in their own houses, have elementary studies and worked as housewives, civil servants, technicians or unskilled labourers.Before the session, 60% did not know anything about EW and the possibility of declaring them.People participating in the survey, and relatives, would feel more reassured if they could declare EW.They would like to register their preferences in their PC records.After the course, the vast majority have a better understanding of the legal, professional and moral limitations of the EW.A total of 70% would sign DEW before civil servants of the EW registry (Health offi ce).Conclusion.Individuals have little information about EW at present.Staff from PC are the most suitable people to inform patients about them and should give the patients a real freedom of choice.This study should be broadened to include people of different ages.