Palliative care and primary health care: Ethical considerations

Palliative Care (PC) is presented as a public health problem, due to the substantial increase in the number of elderly and the prevalence of non-communicable chronic degenerative diseases. The importance of the reorganization of Primary Health Care Services (PHCS) to ensure the provision of this care has become evident. The objective was to identify cases of users, in order to inventory the ethical problems that the team experienced. This is a case study based on a Qualitative approach, using thematic analysis. Two cases were identified, that revealed, as ethical problems, the “responsibility of the PHCS towards the caregivers and families” and the “difficulty of frank and honest communication between the team and the family”. The results indicate that the training of human resources with technical competence and the continuity of assistance in the transition from curative to palliative treatment are factors favorable to the integrality and the obtention of more adequate responses to the ethical challenges that the teams experienced.

随着老年人口规模显著增长与非传染性慢性退行性疾病患病率攀升，姑息治疗（Palliative Care, PC）已成为一项公共卫生议题。为保障此类照护服务的供给，初级卫生保健服务（Primary Health Care Services, PHCS）的重构必要性已日益凸显。本研究旨在识别相关服务对象案例，以梳理该团队所遭遇的各类伦理问题。本研究属于基于质性研究方法的案例研究，采用主题分析法开展数据分析。最终共识别出两起案例，其所暴露的伦理问题分别为“初级卫生保健服务对照护者与家属的责任”以及“团队与家属间难以开展坦诚沟通”。研究结果显示，开展具备技术能力的人力资源培训，以及在治愈性治疗向姑息治疗转型过程中维持照护服务的连续性，是推动服务完整性，并更妥善应对团队所面临伦理挑战的有利因素。