Etične dileme med pravico posameznika do vnaprej izražene volje in dolžnostjo oživljanja zdravstvenega osebja : diplomsko delo

Dolinar, Larissa (author), Ovijač, Darja (mentor), Ravljen, Mirjam (reviewer)

Uvod: Vnaprej izražena volja je posameznikova pravica, v okviru te pravice je pacientu tako omogočeno, da se odloči za možnost zavrnitve oživljanja oziroma t. i. koncept »DNR«. DNR definiramo kot »ukaz« pacienta, da ne želi prejemati ukrepov prve pomoči, v kolikor pride do kardiopulmonalnega zastoja. Na tem mestu se vzpostavlja velika etična dilema. DNR kot pacientova pravica deluje v nasprotju z načeli oz. dolžnostmi nujne medicinske pomoči. Slednja namreč življenje posameznika rešuje, DNR pa odreka zdravljenja in ukrepe v okviru vnaprej izražene volje. Eno izmed ključnih vprašanj je tako razmerje med dolžnostmi izvajanja prve pomoči zdravstvenih delavcev ter načeli in pravicami DNR. Namen: Namen diplomskega dela je predstaviti etične dileme, ki se pojavljajo v razmerju med pravico posameznika do vnaprej izražene volje ter dolžnostjo oživljanja zdravstvenega osebja. Metode dela: Uporabljena je bila deskriptivna raziskovalna metoda z uporabo kritičnega branja relevantne znanstvene in strokovne literature, slednja je bila časovno omejena od leta 2013 do 2023. Razprava in zaključek: Odločitev, ali bo prevladala dolžnost zdravstvenega delavca ali pa pravica pacienta, ni enostavna, zato zahteva proces »tehtanja« med koristjo in škodo. Slednje se ne navezuje le na fizični aspekt zdravja, temveč tudi duhovni, psihološki. Kaj je za pacienta resnično koristno, zato ne moremo oceniti le na podlagi procentualno ocenjenega uspešnega oživljanja, temveč ocenjujemo tudi kvaliteto življenja, ki jo pacientu po slednjem lahko zagotovimo. Pri tem ne gre zanemariti tudi pacientovega odnosa do življenja ali smrti. Kot omenjajo nekateri avtorji, je smrt lahko bolj znosna izbira, kot samo življenje, ki ga zaznamujejo bolečine in trpljenje. Ta vidik nam lahko predstavi le pacient sam, hkrati pa gre na tem mestu za prevlado pravice nad dolžnostjo.

• Language: Slovenian
• Keywords: diplomska dela, zdravstvena nega, etika, zavrnitev oživljanja
• Work type: Bachelor thesis/paper
• Typology: 2.11 - Undergraduate Thesis
• Organization: ZF - Faculty of Health Sciences
• Place of publishing: Ljubljana
• Publisher: [L. Dolinar]
• Year: 2023
• Number of pages: 33 str.
• PID: 20.500.12556/RUL-152538
• UDC: 616-083
• COBISS.SI-ID: 173734403
• Publication date in RUL: 27.11.2023

Secondary language

• Language: English
• Title: Ethical dilemmas between the right of the individual to pre-expressed will and the duty of medical team to resuscitate : diploma work

Abstract

Introduction: A pre-expressed will is an individual's right. Within the framework of this right, the patient is enabled to decide on the possibility of refusing resuscitation, or the so-called me. the "DNR" concept. DNR is defined as an "order" by the patient not to receive first aid in the event of cardiopulmonary arrest. This is where a big ethical dilemma arises. DNR as a patient's right works against the principles or duties of emergency medical assistance. The latter saves an individual's life, while DNR refuses treatment and measures within the framework of a previously expressed will. One of the key issues is the relationship between the duties of first aid of medical professionals and the principles and rights of DNR. Purpose: The purpose of this diploma work is to present the ethical dilemmas that arise in the relationship between the individual's right to a previously expressed will and the duty of the medical staff to resuscitate. Methods: Descriptive research method was used with using critical reading of relevant scientific and professional literature. Literature will be limited in time from 2013 to 2023. Discussion and conclusion: Deciding whether the healthcare professional's duty or the patient's right will prevail is not an easy one, and therefore requires a process of "weighing" between benefit and harm. The latter does not refer just to the physical aspect of health, but also to the spiritual, psychological one. We canoot evaluete what is really useful for the patient, just on the percentage of successful resuscitation, but we also need to evaluate the quality of life that can be provided to the patient after the resuscitation. The patient's attitude towards life or death should also not be neglected. As some authors mention, death can be more tolerable than life itself, which is characterized by suffering on a daily basis. This aspect can only be presented to us by the patient himself, and at the same time it is a question of the supremacy of right over duty.

• Keywords: diploma theses, nursing care, ethics, refusal of resuscitation