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dysthanasia - ITS DEFINITION AND CONCEPTS
1. Concept of dysthanasiaThe dysthanasia (also known as bitterness or aggressive therapy, as it takes into account the suffering of the dying) is to use all means possible, be provided or not to delay the advent of death, although there is hope of healing. It is therefore the opposite of euthanasia.
There have been cases of dysthanasia especially people of high political relevance.Antidysthanasia is known as the attitude of rejection dysthanasia, which in some cases becomes a support for euthanasia and other in defense of orthothanasia.
Both States and the various medical associations have developed laws or codes governing when medical action can be considered overkill.
Factors to consider are the following:
• Do the patient and family
• The medical opinion
• The proportionality of means in relation to the outcome.
Arguably is continuing moral standard treatments for pain relief but can forgo treatment that would only a precarious life.
Implications• Extension unnecessary or futile life support means.
• Location Irreversible
• Malicious Intent
• Medical Angst.
• Ignorance of patient rights.
• Adoption of therapeutic measures that include scientific research.
CriteriaThere are some criteria for the cruelty is checked:
• Futility or ineffectiveness of therapy
• drudgery and hardship for the patient
• Exceptional interventions or therapeutic means (disproportionate means.)
, however, were not leaving ordinary treatments to reduce discomfort:
2. In case of incurable and terminal illness, the doctor should be limited to alleviating the physical and moral suffering of the patient, keeping as much as possible the quality of life that runs out and avoid initiating or continuing therapeutic actions hopeless, useless and obstinate. Assist the patient to the end, with respect for the dignity of man. Three. The decision to terminate artificial survival of brain death should only be taken according to the most rigorous scientific criteria and safeguards required by law care Before suspending two qualified and independent medical team to get the organs for transplant, will sign a document to authenticate the status
code of ethics of the medical college of Spain, no. 28.
2. Defining dysthanasiaThe dysthanasia is the complete opposite of euthanasia, it is the opposition that has the patient, family and even doctors to die. Despite all the complications that may arise around a disease, can be considered dysthanasia an opportunity for those who do not want to die, but it is important that the society that supports human rights in all its features, is dysthanasia considered a "Overkill" against the patient, usually because the patient and subjected to a series of actions that cause suffering beyond measure.
's dysthanasia cruelty is not medical, but if it is clear that this process slows the rest the patient alone, there are cases in which the patient wanted to stop going through all that's happening with death and prevented. From this matrix is generated opinion establishing two camps, the first is in favor of rest and a high of suffering, and the other is the exhaust all possibilities to live and to overcome the disease. The dysthanasia when applied in diseases that have no cure loses some sense presented, the effect that medication can have on the patient's health is zero or negative, however, he continues to manage any method for improvement. In these cases euthanasia would apply, but not done, then it dysthanasia. This method of " Survival "is applied to people who are important to any institution, they may be, from families to governments, which should not a personality of these dies, the dysthanasia may seem selfish, perhaps because a person exercising functions in society can be met by a healthy one, but in this case also associated religious beliefs on certain occasions "Extreme", and that when we speak of an impossibility to live and not allowed eternal rest we are talking about a decision away from reason and consistency with the nature of each. God's timing is perfect and nothing will change.
3. Meaning of dysthanasia
¿dysthanasia, Ortotanasia No Euthanasia?"Much has been discussed about euthanasia. The last ten years in the region of Latin America and the Caribbean, with the introduction of more technology in health care, particularly in emergency and intensive care units, have seen the emergence of some Ethical reflections on the problem but not the abbreviation of "dysthanasia" (antonym Euthanasia) or useless prolongation of human life.
's important, then, to distinguish ethical and values issues in debates about euthanasia and dysthanasia . much is spoken and written about euthanasia.? But what about dysthanasia? There are still a complicit silence and lack of ethical notions, because it produces discomfort bring this discussion with transparency and honesty. In our Intensive Care Units university hospitals the problem revolves around exaggerated therapeutic treatment that leaves the person die with dignity, because you have to try everything but no cure exists, uncritically accepting the dogma: "while there is life there is hope."
Distinction and conceptual precision will help to dispel misunderstandings and prevent discomfort felt by many health professionals, including physicians, if not applicable, or is interrupted, a certain therapeutic procedure against imminent and inevitable death.
What is meant by dysthanasia?If the expression is not popular in Latin America, with the exception of Brazil, it is interesting that Aurelio dictionary of the Portuguese language, defines "dysthanasia" as "slow death, anxious and much suffering." It is a neologism from the Greek, where the Greek prefix dys has the meaning of "bad act." Therefore, etymologically, means dysthanasia exaggerated prolongation of agony, suffering and death of a patient. The term can also be used as a synonym for waste treatment, which results in a slow and prolonged medically death, very often accompanied by suffering.
conduct in this life extends itself, but the process of dying. In the European world discussing therapeutic obstinacy (L'acharnement thérapeutique) in the United States of medical futility (medical futility), treatment futile (futile treatment) or simply futility (Larousse: "minor, trivial") .
most popular speaking is the issue as follows: How long should prolong the process of dying when there is no more hope of life or that the person be healthy again, and all therapeutic effort it really only slows the inevitable, and prolongs the agony and human suffering? Who are interested in keeping the person "living dead"?
world public opinion has been discussed on many occasions the famous patient cases were kept "alive" beyond natural limits, such as Truman, Franco, Tito, Hirohito and, in Brazil, Tancredo Neves, classifying these situations as distanásicas.
conceptual clarity is essential to this controversial field expressions of multiple senses. There are two extremes, and between them, is the orthothanasia:
• Euthanasia (short life)
• The dysthanasia (prolongation of the agony and suffering of death and delay of arrival)
between the two extremes is the attitude honors human dignity and preserves life, and is what many bioethicists, called "orthothanasia" to talk about death with dignity, without abbreviations without unnecessary additional suffering, ie "true death in his time." The orthothanasia, unlike euthanasia, is sensitive to the process of humanization of death, pain relief and lengthening incurs no abusive implementation of disproportionate means producing only additional suffering.
The term "therapeutic obstinacy" (L 'acharnement thérapeutique) has been introduced into the language by French doctor Jean-Robert Debray, the early 50s, and is defined as Pohier, as "... physician behavior means using therapeutic processes whose effect is more harmful effects of evil to be cured, or useless, because the cure is impossible and the expected benefit is less than the expected drawbacks. "
It is important to note that in hospitals in developed countries there is a much more lucid consciousness limits with reference to high-tech medical care in the final stages of life. At the head of the terminally ill are no indications as "Do Not Resuscitate", "It should not be raised", "Code 4", and other indications of therapeutic care limits.
was dysthanasia may perceive has become an ethical problem of first magnitude, for scientific technical progress begins to interfere decisively in the final phase of human life. Today the human being wants to take control of all things, of life and death. The responsibility, yesterday attributed to chance, random processes of nature or "God" (if it was a believer), claims for itself today. The increasing presence of science and technology in the area of health and, especially, in the field of medicine, is a concrete expression of the human desire to change everything and now it plays a decisive role in life that force producing profound ethical reflection.
A specific situation that illustrates this drama is the dilemma dysthanasia the stakes of human dignity. The most technologically advanced countries reflect today about the ethical limits of health interventions in the final phase of life, a reality ever more critical with reference to scarcity of resources and health care. Many situations are considered expenses "unsolvable" while scarce investment in programs and situations for whom "no solution", ie situations where health is possible at a cost much lower and could benefit many more people.
In the struggle for life, in circumstances of imminent and inevitable death, using all available technological arsenal translates into therapeutic obstinacy, challenging the dimension of human mortality, requires those who are in the final phase of life to a painful death. This reality raises complex ethical questions, such as:
• Are we extending the life or simply avoiding death?
• Human life, regardless of its quality, should always be preserved?
• Is the physician's duty to maintain indefinitely the life of a person whose brain has been irreversibly injured?
• To what extent is lawful sedate the person using medication that relieves pain and indirectly shortens the life of the person?
• Should use all available treatments to prolong life the terminally ill or could stop treatment?
• Do I have to keep patients in a persistent vegetative state?
• Should I use an active treatment in infants with "serious congenital deficiencies incompatible with life"?
• Is it possible to maintain the Life in these circumstances?
• Should be maintained those lives? And if not, why?
These are some of the dilemmas that must be confronted and have caught the attention not only of those who work in the area of health as experienced professionals, but the general public.
This issue gains more space on the agenda of the media around the world and international organizations like the World Health Organization (WHO). It publishes every year an overview of health in the world, the year 1997, entitled "conquering suffering enriching humanity," says some priorities for action to improve the human ability to prevent, treat, rehabilitate and, as possible, cure the discomfort, thereby reducing the enormous suffering and deficiencies occur.
Among the priorities cited include:
• "The pain relief, reduction of suffering and palliative care for those who have no prospect of cure."
In his conclude the summary notes that inevitably every human life comes to an end. It is necessary to ensure that elapses in a dignified and painless as possible, because your care deserves as much priority as all other stages, not only by medical professionals or social services, but the entire society.
's bioethics and especially the ethical discussion concerning dysthanasia can not forget the broader context (macro) in Latin America, a region marked by exclusion and inequality, which reduces the opportunities to live with dignity and in which the dying process is set in collective abbreviation of life ("mistanasia").
Obviously, the cry that comes from that fact before it in favor of a "death with dignity" is to "live with dignity". The challenge is to develop a libertarian mystique for a bioethics that strengthens our commitment to the promotion of health and decent life, especially for the most vulnerable sectors of the population.
Ethical reflection on dysthanasia is relevant to the Latin American reality in the teaching hospitals that train future health professionals for institutions with technology, for example, intensive care units and centers of art diagnostic (MRI, linear accelerator, etc.). Sumase to that the awakening of the consciousness of citizenship (the right to health and status of patient rights, for example), although emerging in our reality of exclusion and dependency, in which people begin to learn more and to require your rights to life and health are respected, questioning procedures and therapeutic care in situations of end of life and address the shortage of resources. In conclusion, the issue is current, emerging and compelling. "