Article information
Abstract
Decision-making in COPD is complicated by the lack of clear prognostic factors. In this clinical situation it is also necessary to include the desires, values and choices of patients. The problem is more complex in the critical episodes, where the patients are incapable to make decisions. The instruments that allow incapable patients to represent themselves, the kind of patients who could benefit from its use, and the Spanish legislation on the matter, are presented in the first part of the work. The paper goes on to explain how to apply advance directives to the case of COPD. The article concludes that the appropriate use of advance directives and advanced care planning increases the quality of decisions at the end of the life of the patients with COPD.”
Keywords:
Chronic obstructive pulmonary disease
Advance directives
Rejection of treatment
Quality of life related to health
Advance care planning
Bioethic
Resumen
La toma de decisiones en la EPOC es compleja por la ausencia de indicadores pronósticos claros. En estas situaciones clínicas es aún más necesaria la introducción de los deseos, valores y elecciones de los pacientes. El problema es aún más complejo en los episodios críticos intercurrentes, en los que el paciente no suele ser capaz de hecho. En la primera parte del artículo se definen los instrumentos que permiten que un paciente incapaz se represente a sí mismo, el tipo de pacientes que más se pueden beneficiar de su uso, y la legislación española al respecto. En la segunda se aplica al caso de la EPOC. El artículo concluye que el uso adecuado de las directivas previas y la planificación anticipada de decisiones incrementa la calidad y el fundamento en la toma de decisiones al final de la vida de los pacientes con EPOC.
Palabras clave:
Enfermedad pulmonar obstructiva crónica
Directivas previas
Rechazo de tratamiento
Calidad de vida relacionada con la salud
Planificación anticipada de decisiones
Bioética
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