بررسي نگرش پزشكان در مورد بيماران ترمينال

Evaluating physicians points of view about terminally ill patients

In facing with terminally ill patients, many ethical issues emerges such as patientʹs information about the disease and getting patientʹs idea about supportive and curative measures, starting and stopping life saving treatments, and finally euthanasia. Considering different cultures, there are different ethical aspects which may affect decision making about terminally ill patients and needs to be further evaluated. According to the lack of study in this field in Iran, the aim of this study was to describe the attitude of Iranian specialists about ethical issues in the end of life care. In this study we interviewed with 20 specialists in the fields of nephrology, hematology, anesthesiology, neurology, surgery, neurosurgery and oncology; who are facing with terminally ill patients more than the others. Analysis revealed that declaring disease information to the patient and his decision are the most important factors affecting patientʹs family and the diagnosis and decision of the physician in sustaining life saving treatments are in the second order, although the definition of terminal illness was different between specialists and even in contrast with ethical resources. Considering western country model, while this is not in agreement with patientʹs autonomy, it is compatible with the eastern ethical model. It seems that in this approach beneficence, non malfeasance and legal issues are more important than patientʹs autonomy. By accepting this approach, there is no need for advanced care management