Iniciar ou não a ventilação mecânica invasiva – uma aplicação dos quatro princípios éticos

Translated title of the contribution: Initiate or withhold invasive mechanical ventilation – an application of the four ethical principles

Nuno Caires, João Paulo Correia, Corinna Lohmann

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction: Medical decision regarding withholding treatment is a true ethical challenge. Contemplation over autonomy, beneficence, non-maleficence, and justice can guide us through this decision to reach the best possible clinical outcome. Aim: To promote a more adequate clinical decision, based on the four ethical principles. Material and Methods: Through a clinical case illustration of idiopathic pulmonary fibrosis, a reflection based on the four ethical principles about initiation or withholding of invasive mechanical ventilation was intended. For that effect, a classic review of the literature was made regarding the four ethical principles and the initiation of invasive mechanical ventilation in idiopathic pulmonary fibrosis.
Discussion: After a multidisciplinary ethical and clinical reflection, it was considered that the patient would not benefit from invasive mechanical ventilation. The patient was informed of his actual state of disease and initiation of comfort measures was agreed, including high-flow oxygen therapy. Conclusion: The application of the four ethical principles gives a moral, fundamental and mutual language and structure, which should be complement with a compassive support of the family, an enlightening communication and an essential information sharing. An early follow-up by a palliative care team is of the essence.
Translated title of the contribution Initiate or withhold invasive mechanical ventilation – an application of the four ethical principles
Original languagePortuguese
Pages (from-to)56-61
Number of pages6
Journal Cadernos de Saúde
Volume13
Issue number2
DOIs
Publication statusPublished - 1 Jul 2021

Keywords

  • Palliative care
  • Principle-based ethics
  • Idiopathic pulmonary fibrosis
  • Withholding treatment
  • Clinical ethics

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