Integrating Palliative Care and Intensive Care

Nationwide research project funded by Fundação Grünenthal and Fundação Merck, Sharp and Dohme about the integration of palliative care in intensive care units.

Project InPalIn studied the integration of palliative care (PC) in intensive care (IC) using a double and intertwined theoretical framework combining bioethics with organizational development and change. First, by integrating the core principles of PC in IC, the ethical principles of autonomy, beneficence, non-maleficence, and justice are fostered together with the ethical principles of dignity, integrity and vulnerability. Second, several organizational initiatives have been described worldwide on integration and require a careful consideration of concepts and organizational models.

The main objectives of this project were: (i) To ethically frame and understand healthcare professionals’ perspectives about integrating PC and IC; (ii) To understand professionals’ perspectives about the integration of PC and IC; and (iii) To assess what organizational models are preferred by these professionals.

A nationwide mixed-methods study, including the Azorean islands, combining interviews, focus groups, and a survey was implemented from 2016 to 2019.

InPalIn was the first research study addressing the integration of PC in IC in Portugal, combining two intertwined theoretical approaches: bioethics and organizational sciences. The combination of research methods provided a greater understanding yield. Findings showed differences in concepts and preferred organizational models for integration between IC and PC professionals and a myriad of ethical challenges. Tailored and ethically sound strategies are needed to foster the successful integration of PC in IC.