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Challenges to implementation of advance directives of will in hospital practice

ABSTRACT

Objective:

to understand the difficulties and limitations in the implementation of advance directives of will in the hospital context.

Method:

qualitative, exploratory and descriptive study conducted by means of semi-structured interviews with nurses, resident physicians and family caregivers. The data were analyzed by using discursive textual analysis based on the framework of bioethics principles.

Results:

the following categories emerged: Terminality as an expression of loss and cure as an option for care; concerns about legal implications; advance directives of will demand patient autonomy and proper communication.

Conclusion:

limitations and difficulties in practice of advance directives of will from the perspective of the participants show, apart from countless conflicts and dilemmas regarding end-of life matters, that impending death experiences obstruct patients' wishes.

Descriptors:
Advance Directives; Terminally Ill; Nursing; Personal Autonomy; Caregivers

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