Ethics in Health Care: The Foundation of Alterity
UNIT 2 .- MODEL ALTERITY
What ethical foundation can contribute to the dynamics of health care, both to guide us in that task, to ensure the universality of the human action?.
We propose an ethical foundation of care in Otherness. To this end, we describe the first ethical experience which develops health care: the otherness of the “other me” needy health.
a). Constitutively are “version”:
human beings we are constitutively referred to the other. The other version is primarily a matter of fact, it is “version” real and physical, not merely existential or intentional. (Eg A child is discharged into something, the mother or who serves, who will receive nutrition or where you will find under it, is a radical way of being himself and it was originally part the encounter with others). Man can not be a person rather than personalizing and it should make your life with things, with other men and with-I itself. His relationship with his surroundings is essential, intrinsic constitutively, both of person and their personality. The relationship in person is something of “theirs” and will only fulfill itself your being interacting with others. The person is also precisely for this task and openness can be easily hurt.
b). In socorrencia:
The relationship between ‘nutritional needs of children “on the one hand, and” provide relief “on the other, we call” HELP “but when the child shows his intelligence, and takes care of Indeed, their tendency to seek help becomes “HELP.” The need that the body has of others is a need for relief, socorrencia. The Socorrencia is reflected in the State as it is, for example, illness or needs to have the sick.
c). The other:
When man, the other by its constitutive “version” and his health problem before us, health professionals, as being needy, needy, is that we are calling. Call from real otherness that is his neediness. It is called the “other me” what is the vocation of the therapist or caregiver. This is what pro-vocation to homo medendi peritus, which gives reason and what determines health care and above all, is what pro-vocation “way of being,” the “character”, the “ethos” doctor, nurse or other helper. Health professionals and place when we sense in our work each day we consider the limits of human existence, the ontological and extreme fragility of being human. We can therefore say that the nurse access to the reality of another personal being needy, health, rule out any speculative or uncompromising analysis and must assume a unique ethical relationality. Consequently, we understand that health care (professional behavior Nurse @ s) by both the constitutive“Version” of the human being sick to your caregiver, as well as the constitutive “version” of the caregiver, has its ethical foundation in the experience of otherness, felt the responsibility to the other and the other man’s needy health. The ethics of alterity requires me to him rather than nothing and forces me to be caring for him and care for him.
The ethical foundation of care is on the other, which is why home as long as you are in need, socorrencia or disease. The vocation is the nurse but the needy which is the pro-vocation, calls from the need from the neediness. All care must be detached from the other, from the needy.
UNIT 2 .- TRIAL ETHICS
Our moral personality (our conscience), it builds up over time and evolves through a stage of maturity. Takes shape through a learning process involving socio-cultural, educational, emotional and above all influences the changes in the way of reasoning about ethical issues and how to judge them, ie in the way of judging . The prescriptive moral judgments are judgments which aims to guide the actions and behavior. The nurse must develop and issue its own opinion. There are different types or levels of trial by Kohlberg:
Pre-conventional level,
is the less mature moral reasoning. The person means just what it is selfish. At this level, follow the rules. Child is a trial, individualistic, selfish … example: the child.
Conventional level:
one focuses on ethical issues in accordance with the rules. This means as good as that society accepts, one adapts to what society wants. People identify with their role as moral or social role.
Postconventional level: the person distinguish between universal ethical principles and among the forms of behavior that exist in society, and is able to build on these principles to develop the justice or goodness in their behavior, and therefore, commits his life according to that trial that has developed. Applied to nursing, this is the more mature level that we can have in making decisions and solving problems.
ITEM 3. NURSING CARE AS A HUMAN RIGHT
ICN statement on the practice of nursing care, both in care and management, research and education, mean effective recognition of human rights in the health field.
All nurses are linked and professional nature, to safeguard and respect human rights (of every human).
In the performance of nursing care is freedom and equal dignity for all.
Our work was a further materialization of these two values: Freedom and Dignity.
ITEM 4. FEATURES FOR HUMAN ACTIVITY IS A PROFESSION.
1 .- The occupation is a human activity by which a specific service is provided to an institutionalized society.
a) Human activity, Ie by the people, and is therefore a product of the action of specific individuals, such as: Teaching Politics.
b) specific services:
One, which is provided by a professional society exclusively.
With clearly defined benefits, which everyone knows what to expect and what to require of them.
This is an essential task, of which the company can not do without.
c) How institutionalized, in that it embodies the institutional level activities
2 .- It is a human activity developed from a vocation and a task or tasks assigned. Professional is expected to be delivered to it generously.
3 .- The activity is realized by a particular set of people, professionals.
4 .- Who operates the business together form a group to obtain control over the exercise thereof.
5 .- Access to the profession requires a long process of theoretical and practical training.
6 .- The exercise of the profession requires the autonomy of the professionals to develop it.
7 .- The right of autonomy is for the duty of responsibility for acts and technical careers.
8 .- It is expected that professionals do not practice the only profit.
9 .- There is a clear distinction between the end of a profession and the interests pursued by the people who practice it.
ITEM 4. NURSING EXCELLENCE TASK.
There are two ways that integrate professional excellence, the first takes into account the knowledge and professional skills and the second relates to the ethical profile of the person, ie that all the skills and knowledge meet the ethical good and root our career is nursing care and the interpenetration of the two is achieved professional excellence nurse.
There are attitudes that ensure the quest for professional excellence:
Compassion: Feeling of ownership of the problem of the other.
Vocation: The Call of the other, of being needy and I have to give good response.
Communication skills: It is essential to communicate with others and the patient.
Responsibility.
Technical Competence: Knowledge.
Self-Esteem: Feeling always proud of being a nurse and loving and professional.
Ability to promote independence.
ITEM 5. CODE OF ETHICS OF NURSING
ITEM 6. RELATIONSHIP BETWEEN ETHICS AND LAW
From the first course we study bioethical issues in nursing care, we have been highlighting that ethics is a practical knowledge that is intended to guide human behavior. We have also made it clear, as we recall in the first issue of “Law and Ethics”, which to humans is an ethical subject, first in its structure, intelligence and freedom as such it is human, and second, because that conduct is filled with content “good” or “bad” depending on whether or not for the good purpose, ie the effective recognition of human dignity of every human.
Now, in this beginning of item 6, we introduce a new element: that the legislation law expression (we’ll see what this means), is also a practical knowledge, trying to guide and direct human action, our behavior. This means that these two practical knowledge, ethics and law, have their root cause in the specific nature of human beings, which is the intelligence and freedom, and both tend to direct knowledge and human action prescribed.
So what are the differences between practical knowledge, as the two guiding human action? The ethics and practical knowledge of legislation are different from each other by the way they bind, ie, prescriptive tone of each, by the way they require. Thus, these two practical knowledge are not identical but they are complementary. Let’s see.
ITEM 6. SOURCES OF LAW
The law: rule of law understood as state, defined as the rule of law
made legal, issued and published by competent state bodies.
Their requirements are:
Legality, ie to be established by the procedure and the requirements that the law requires to legislate.
Advertising
The practice: effective practice is repeated in a particular manner. Is the standard created by the use and social will. The custom, as a source of law, requires:
Use
The need
General principles of law: They are the fundamental ideas that report positive law contained in laws and customs. They are, in essence, the guidelines derived from justice as understood our legal system enshrined in the doctrine and jurisprudence.
ITEM 6. CIVIL AND CRIMINAL LAW
D. Civil: The general private law aimed at regulating the person in their organizational structure, the rights accruing to him as such and in the relations arising from its integration into the family and to be the subject of their heritage within the community.
D. Criminal:
Subjective: The state power to enforce the rule in the manner and by the means established by law, namely, obedience to the criminal legal standards.
Objective: Set of public law, that in order to protect certain legal rights, describe crimes and combine sentences or security measures.
Public Law: The set of rules governing the organization and activities of State and other public entities and their relationships as such, that is, officially, among themselves or with individuals.
Intervention by the State and public bodies are imperium, or public authority. This issue is reflected in administrative law, in political rights, criminal law, in tax law, etc.
Private Law: A set of rules governing respect for individuals and their relations with each other, if they do public entities involved with the character of individuals.
ITEM 7. PATIENT RIGHTS
1 .- In respect to his personality, human dignity and privacy, but may be discriminated against because of race, social, gender, moral, economic, ideological, political or trade union.
2 .- Information on health services they can access, and requirements for its use.
3 .- The confidentiality of all information regarding your process and your stay in public and private health institutions to collaborate with the public.
4 .- To be warned if the forecasting procedures, diagnosis and treatment to be applied, can be used in terms of a teaching or research project that in any case, may involve additional risk to your health. In any case it will be necessary prior written consent of the patient and physician acceptance and management of the relevant hospital.
5 .- A which is given in understandable terms, he and his family and associates, full and continuous verbal and written information about the process, including diagnosis, prognosis and treatment alternatives.
6 .- In the free choice among the options presented by the chief medical officer, if any, being necessary to the prior written consent of the user to perform any work, except in the following cases:
a) When the intervention does not pose a risk to public health
b) When not qualified to make decisions, in which case the right shall belong to family members or people close to him
c) When the emergency does not allow delays in being able to cause permanent injury or risk of death exist.
7 .- To be assigned a doctor, whose name he will announce who will be your main contact with the healthcare team. In his absence, another medical team will assume this responsibility.
8 .- To be told certificate to extend their health, when their demand is established by a law or regulation.
9 .- To refuse treatment, except in the cases mentioned in paragraph 6, having to do voluntary discharge request in the terms set out in paragraph 4 of the following article.
10 .- To participate, through the Community institutions, in health activities, in terms of this Act and the provisions developing.
11 .- A written the record of the whole process. After the user stay in a hospital, the patient, family member or the aide to receive his discharge report.
12 .- To use the channels of complaint and suggestions proposed schedule. In either case you should receive a written response within the time limits established by regulation.
13 .- A choice of doctor and other health professionals qualified in accordance with the conditions specified in this Law, the provisions enacted for their development and in regulating health work in Health Centres.
14 .- To obtain the drugs and medical devices deemed necessary to promote, preserve or restore their health, as set forth in regulations established by the Administration.
15 .- In keeping with the peculiar economic system of each health service, the rights referred to in paragraphs 1, 3, 4, 5, 6, 7, 9 and 11 of this Article shall be exercisable also in relation to private health services.
ITEM 7. HOSPITAL PATIENT RIGHTS: BACKGROUND AND DEVELOPMENT OF THE MOST MAJOR
Background:
If every human being, by being a person entitled to health care and, therefore, social solidarity, more so even deserve when you are in a situation of greater vulnerability such as inpatients.
Formulation of the main rights
1 .- Receiving health care service that puts the person all the technical and human resources according to their disease and the possibilities of the center, without discrimination based on age, sex, race, ideology and socio-economic status.
2 .- To be treated with flexibility so that the paperwork does not delay patient care or not to delay its entry.
3 .- To be treated, by all school staff, with respect for their dignity.
4 .- To be treated with respect in regard to their personal privacy.
5 .- Be treated with respect and recognition in their religious and philosophical convictions.
6 .- Continue to maintain the relationship with family and friends and communication with the outside.
7 .- Receive understandable, adequate and continuous over the center which is located on your physician.
8 .- Having a medical history and have access to it.
9 .- Keeping the secret about his illness and the medical history data
10 .- Choosing to leave the hospital at any time.
11 .- die with dignity.
12 .- To know their rights, they are widely disseminated among patients and hospital staff and to be respected.
13 .- Present suggestions and complaints about the operation of the hospital and that they be studied and answered.
ITEM 8. SICK RIGHT TO INFORMATION (SUMMARY T8)
Information, such as right and need:
To start note is that not the same or more live anxiety of not knowing what happens, because the unknown is distressing and negative, on the contrary, the information makes us face things more calmly.
When considering the patient as a person, understand that it is able to choose among alternative courses of action. To the person is autonomous and has the capacity to choose, you need information as it is a right and necessity.
Informed Consent:
It has two parts, and consists in explaining to a mentally competent patient and attentive to their disease and response to make (first part) in order to request approval to be subject to such procedures (Part II)
Report WHAT:
Diagnosis, prognosis, testing, tto and alternative procedures.
On the “truth” of information:
For pity, that person should be lying??
To grant autonomy must know reality, only in special cases can be qualified truth. Terminal cancer.
Who reports?:
Normally the team leader reported. If there are people on the team with closer proximity to the person can tell it.
How do I report?:
Diachronic information and a proportional manner, as it becomes aware of information. Never hit.
When to report?
At the appropriate time.
Why report?
To reduce disability, anxiety, dependency, mistrust. Increases accountability, collaboration and realism in the patient.
Difficulties in information:
A part of health personnel, as there is some anxiety, even by the prejudices that we can have on patients or even the echo of having more knowledge about the patient.
By the patient’s culture, the critical situation and personality of the subject.
ITEM 9. THE RIGHT TO PRIVACY AND SECRECY IN THE CONTEXT OF MEDICAL HISTORY
HISTORY: clinical Learn where all the information that the patient has medical staff.
There is also the information that we collect through exploration and testing performed and finally the patient’s diagnosis and all relevant data.
Confidentiality: The communication process between the subject with health and skilled health personnel. This confidence is expressed in two legal forms: privacy and confidentiality.
It ranges from the start of care and health care so far.
Privacy: Everyone has a specific area reserved to our personality.
Here are the feelings, desires, dreams, thoughts, joys and sorrows, regrets, shame …
A privacy always accompanies the assault, is a mechanism of protection of personal privacy. Intimacy is a requirement to live, because they can only live, communicate and engage people who have privacy.
Privacy is a right and a value inherent in the clinical setting, for this there are 3 reasons:
The patient is directed to us from their vulnerability.
The nature of the consultation.
Share confidence.
Confidentiality: moral commitment not to show the news known or received by a confidential way. This is to safeguard the personal identity, to ensure social harmony and interpersonal loyalty manifest.
There are 3 types of professional secrecy: Natural (That which by itself can not be disclosed), Engagement (promise not to speak) and confident and professional.
There are 5 exceptions:
When the person wants you to know your illness.
When information is required by law.
There are medical reasons that need not have consent.
Public health problem. HIV
Clinical research.
ITEM 10. CONCEPT OF LAW AND FEATURES
Concept: Proposition prescriptive ordering something that has been promulgated by those who can. Can be applied in a coercive, if not voluntarily comply.
Features:
a) Extrinsic:
Overview: It is a law for the majority and should be respected by all.
Tender for the common good, the good of all to protect individuals.
Established by the government: In our country the courts, Congress and Senate composed.
b) Intrinsic:
Justice: This is the reason for the law. The judgments will be fair when there is a correct application of the law.
Permanent basis: All laws should last a certain time to apply.
Published and publicized: It must be issued by the State Gazette and advertised.
Items 11 and 12. ANDALUSIA HEALTH LAW
Introduction: The Act aims to regulate the proceedings to enable the realization of the right to health protection of citizens in Andalusia, the system definition and implementation of the rights and duties of citizens for health services the region and the general management of health activities in Andalusia.
Basics:
1 .- Universality and equity in access to public healthcare system in Spain.
2 .- Achieving social equity and regional balance in the provision of health services.
3 .- Conception comprehensive health promotion activities including health education, prevention, care and rehabilitation.
4 .- Functional integration of all public health resources.
5 .- Planning, effectiveness and efficiency of health care organization.
6 .- Decentralization, autonomy and accountability in the management of services.
7 .- Participation of citizens.
8 .- Participation of workers in the health system.
9 .- Promoting individual and social interest for the health and health systems.
10 .- Promotion of teaching and research in health sciences.
11 .- Continuous improvement in the quality of services.
12 .- Effective and efficient use of health resources.
Items 11 and 12. RELATIONSHIP WITH PRIVATE ENTERPRISE.
The SAS has an agreement with private companies developing the same functions as in public institutions. This collaboration is part of what is known as public law.
, To permit the agreement must exist:
Prior approval of the center.
Accreditation Center.
To comply with current tax legislation on labor and social security.
There is an adjustment to the rules and regulations affecting health activities that were agreed.
ITEM 13. BASIC LAW REGULATING PATIENT’S AUTONOMY.
Purpose of the law: It aims to regulate the rights and obligations of patients, users and professionals as well as the institutions and public and private health services, in terms of patient autonomy and clinical information and documentation.
Ppios basic
1 .- dignity, autonomy and identity.
2 .- With the consent of patients.
3 .- The right to free choice.
4 .- Every patient has the right to refuse tto except legally.
5 .- Patients have a duty to provide all information about your physical condition or health of a true, and to assist in obtaining where necessary for reasons of public interest or health care.
6 .- Obligation to the proper professional services, information and clinical documentation.
7 .- Save secrecy and confidentiality due.
On the clinical history
The law develops good content referred to issues of right to health information and privacy rights in their respective chapters II and III. Since in our program of the subject we discussed separately the two issues of the right wing and the right information to Privacy, then we refer to the content to develop the law regarding the medical history.
Definition
The medical history includes all documents relating to each patient care processes, with the identification of doctors and other professionals who have participated in them, in order to obtain the fullest possible integration of the clinical records of each patient at least in the area of each center.
Each center will file the medical records of patients, irrespective of the paper, audiovisual, computer or other authority stating, so as to ensure their safety, proper storage and retrieval of information.
The health authorities will establish mechanisms to ensure the authenticity of the content of the clinical history and changes in it as well as the possibility of future reproduction.
The Autonomous Communities will adopt the provisions necessary for health care facilities to take appropriate technical and organizational measures to archive and protect medical records and prevent their destruction or accidental loss.
Content
Incorporate medical history information considered crucial to the accurate and updated knowledge of the health of the patient. Any patient or user is entitled to the record, in writing or better technical support, information obtained in all healthcare processes, made by the health service at both primary care and specialty care.
The medical history will be mainly aimed at providing health care, leaving a record of all data under medical criteria, allowing accurate and updated knowledge of health status. The minimum amount of history is as follows:
a) The documentation on the clinical sheet statistics.
b) The entry clearance.
c) The report of urgency.
d) The history and physical examination.
e) The Evolution.
f) Medical orders.
g) Wing interclinical.
h) The reports of complementary.
i) Informed consent.
j) The report of anesthesia.
k) The report record operating room or delivery.
l) The pathology report.
m) The development and planning of nursing care.
n) The therapeutic application of nursing.
o) The graph of constants.
p) The clinical discharge report.
Paragraphs b, c, i, j, k, l, o and p are only due on the completion of the clinical history.
The completion of medical records in the aspects related to direct patient care will be the responsibility of the professionals involved in it.
The medical history will be based on criteria of unity and integration, at least every charitable institution, to facilitate better and more timely knowledge data practitioners of a particular patient in each care process.
ITEM 14. WHAT IS ABORTION? “TYPES?
Concept: Termination of pregnancy when the fetus is not viable. From the second month is considered fetus.
Types:
Therapy: When continuation of pregnancy is a danger to the mother. For example, ectopic pregnancy.
Eugenics: The break is intended that the new being is born with abnormalities. Spina bifida.
Humanitarian law: when the pregnancy resulted from rape.
Psychosocial economic problems, housing, extramarital relationships. Are in most cases voluntary abortions.
Article 13. Common requirements.
Are prerequisites for the voluntary interruption of pregnancy:
I.-It is practiced by a physician or under his direction.
Sec.-carried out in public or private health center accredited.
Tercero. “That is done with the express written consent of the pregnant woman or, where appropriate, legal representative, in accordance with the provisions of Law 41/2002, regulating and Patient Autonomy and Rights Obligations regarding information and clinical documentation.
Express consent may be waived in the case referred to in Article 9.2.b) of the Act and
Cuarto.-For women 16 to 17 years, consent to the abortion will correspond exclusively to them under the general arrangements for older women.
At least one of the legal representatives, parent, people with parental or guardian of women between these ages must be informed of the decision of the woman.
This information will be dispensed with when the child correctly contends that this will cause a serious conflict, manifested in certain danger of domestic violence, threats, coercion, abuse, or a situation of uprooting or helplessness.
Article 14. Termination of pregnancy at the request of the woman.
Pregnancy may be interrupted within the first fourteen weeks of gestation at the request of the pregnant woman provided that following conditions are fulfilled:
a) That it has informed the pregnant woman on the rights, benefits and public aid to mothers, on the terms set forth in paragraphs 2 and 4 of Article 17 of this Act
b) That after a period of at least three days, from the information referred to in the preceding paragraph and the implementation of the intervention.
Article 15. Discontinuation for medical reasons.
Exceptionally, may terminate their pregnancies for medical reasons when any of the following circumstances:
a) not exceed twenty-two weeks gestation and whenever there is serious risk to life or health of pregnant women and so stated in an opinion issued prior to the intervention by a physician or other medical specialist of the practice or direct. If life-threatening urgency for the pregnant woman’s opinion may be disregarded.
b) Not to exceed twenty-two weeks gestation and there is any risk of serious fetal anomalies, and so stated in an opinion issued prior to the intervention by two physicians other than the practice or direct.
c) have been detected fetal anomalies incompatible with life and so stated in an earlier opinion by a doctor or medical specialist, other than practicing the intervention, or when the fetus is detected in an extremely serious and incurable at the time diagnosis and so confirmed a clinical committee.
Article 16. Clinical Committee.
1. The clinical committee referred to in the preceding article shall be composed of a multidisciplinary team consisting of two doctors specializing in gynecology and obstetrics and experts in prenatal diagnosis and a pediatrician. Women can choose one of these specialists.
2. Diagnosis confirmed by the committee, she decided on surgery.
3. Each Autonomous Region, there is at least one clinical committee at a public health network. The members and alternate members, appointed by the competent health authorities shall be for a period of not less than one year. The appointment shall be published in the Official Journals of the Autonomous Communities.
4. The specific clinical performance of the Committee shall be determined by regulation.
Article 17. Information prior to the consent of the voluntary interruption of pregnancy.
1. All women who express their intention to undergo an abortion receive information about the different methods of abortion, the conditions for termination under this Act, public schools and accredited to be able to direct and procedures to access the service, and the conditions for coverage by the public health service concerned.
2. In cases where women opt for abortion regulated in Article 14 will also receive a sealed envelope containing the following information:
a) Government assistance available to pregnant women and health coverage during pregnancy and childbirth.
b) Labour rights relating to pregnancy and maternity benefits and public assistance for the care and attention of children, tax benefits and other relevant information on incentives and assistance at birth.
c) Information about facilities available to receive appropriate information about contraception and safe sex.
d) Details of centers where women can receive voluntary counseling before and after the abortion.
This information must be entered in any public health center or centers accredited for the voluntary interruption of pregnancy. Together with the information in a sealed envelope is handed the woman a document showing the date of delivery to the purposes stated in Article 14 of this Act
The development, content and format of this information should be determined by regulation by the Government.
3. In the event of termination of pregnancy under the letter b of Article 15 of this Act, women will receive in addition to the information provided in the first paragraph of this article, written information on rights, benefits and grants to support existing public empower people with disabilities and the social network of social assistance to these people.
4. In all cases, and prior to the giving of consent, it shall inform women in terms of Articles 4 and 10 of Law 41/2002 of November 14, and specifically on the medical, psychological and social implications of continued pregnancy or abortion.
5. The information provided in this Article shall be clear, objective and understandable. In the case of persons with disabilities will be provided in accessible formats and media, appropriate to their needs.
Be communicated in the documentation provided, that such information may be provided in addition, verbally, if she so requests.
ITEM 15. DEFINITION OF ABUSE AND RIGHT TO FOOD
Definition: Any act or omission that causes damage, intentional or not, practiced on people 65 and older, occurring in the family, community or institutional, that harms or endangers the physical, mental, and the principle of autonomy or other fundamental rights of the individual. Types:
Physical: hitting, hitting, pinching, pushing … We can also include sexual abuse.
Psychological or emotional insults, isolation, guilt, threats of abandonment …
Economic: Theft, misuse of money, illegal exploitation of their funds …
Right to food: In this legal area is organized every assistance and care to ethical and emotional development that can contribute to community life among relatives, and in him the figure of the right food.
The right to food is a right attributed to a person in need of certain relatives to claim what is considered essential for a decent life. It is a right referred specifically to support, to the room, clothing and medical care.
This right is recognized and generally accepted in the downline (parents to children or grandparents to grandchildren) is difficult to be accepted in the ascending line. Therefore, to deprive more of such goods is something required by law before a court.
The right to food is not always conditioned by the payment of a sum of money, you can choose to receive the food at home and to cover basic expenses for a dignified life, or can be fulfilled by a person or institution (Private) that will assist the full extent required by law.
ITEM 16. STATEMENT WILL EARLY CONCEPT AND PROCEDURE
Concept: The statement of advance is the right that a person has to decide on health policies for which he may be in the future, on the assumption that when the time is not capable of deciding for itself.
Every person can exercise adult, emancipated minor or minor whose maturity allowed to make such a statement.
Procedure: First, it is necessary forms found in the Inters @ s, in the provincial health and in all public health centers in Spain. These can be completed in paper or directly on Inters @ s, in both situations be considered as a draft.
To formalize the registration must be submitted in the provincial health, with completed questionnaires and passport. The process is very simple: you simply make an appointment at your health answers.
Special Situations:
If you decide to appoint a representative to decide for you if you can not express their will by itself, requires that this representative consents in writing in a document of acceptance, which is available on interest @ s, provincial departments of health and in all public health center of Andalusia.
If the registrant is an emancipated minor, you must file the court order of emancipation.
If the author of the declaration does not know or can not sign, he can sign a witness to be acreditarse.Si the documentation is complete and meets all requirements are included in the Register of Wills Vital Advance.
ITEM 17. DEATH WITH DIGNITY.
Approach:
Good health often eliminating the request for euthanasia or assisted suicide, but there are patients who request it:
Loss control bodily functions.
Reduced autonomy. Fear of being a burden.
Dependence on others.
Right to die with dignity:
The meaning of dying with dignity is not artificial prolongation of life, use of pain therapies or tto of troublesome symptoms, to alleviate the sufferings whose origins may be diverse, support and develop a close presence, help you be aware that you may die , help you live this experience of death.
Euthanasia should be reserved to describe those interventions which aims to end the life of a person by the health professional, if the person so ordered. When a person is autonomous and is mentally competent.
The involvement of health personnel is the cause of death.
The right to die with dignity: Recognize this right includes:
Know the truth.
If you want tto receive healing.
Reject if you want all kinds of ttos.
Receive, if you want, the care needed to live comfortably in the disease process and death.
If you want tto receive proper physical pain, psychological pain relief and adequate support for the spiritual pain.
Choose whether you want the time and manner in which death will occur.
Is it ethical to respond positively to those who want to die and asks for help?
In our professional work:
Relieve pain, not ending life. Principle of nonmaleficence do no harm to anyone
Proportionality test.
On the use of invasive procedures: The intent is to relieve, such as with morphine.
Quadriplegics situation: It is difficult for a terminal illness is not biologically justified use of invasive procedures or euthanasia. The request for a great experience of loneliness, they consider their actual experience is less worthy than death.