Publication: Conocimiento y actitudes ante las Instrucciones Previas de pacientes y profesionales sanitarios en la Comunidad de Madrid
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2017-02-28
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Universidad Complutense de Madrid
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Abstract
Introducción. A través de las instrucciones previas (IP), un ciudadano puede dejar por escrito los cuidados médicos que quiere que se sigan con él, en caso de que su capacidad para expresarse se vea comprometida. Este documento tiene su fundamento en la bioética, en concreto en el respeto a la autonomía del paciente. Tradicionalmente el modelo paternalista era el que determinaba la relación médico-paciente. Desde finales del siglo XX se ha ido dando mayor importancia a las creencias y opiniones de los pacientes, siendo estos los que en última instancia eligen. Es lo que se denomina modelo deliberativo. El origen histórico de las IP se encuentra en lo que en EEUU se denominó living wills. En cuanto al marco legislativo es en la Ley 41/2002, básica reguladora de la autonomía del paciente, en concreto en su artículo 11, donde se regulan estos documentos, que deben constar siempre por escrito. Esta ley deja abierta la regulación específica a las diferentes Comunidades Autónomas, por ello en mayo de 2005 la Comunidad Autónoma de Madrid (CAM) aprobó la Ley 3/2005. Existe un registro a nivel nacional (Registro Nacional de Instrucciones Previas) regulado por el Real Decreto 124/2007. A lo largo de los últimos años diversos estudios han puesto de manifiesto la existencia de un alto nivel de desconocimiento de las IP tanto por parte de los pacientes, de sus familiares y de los profesionales sanitarios. Todos estos estudios se han desarrollado en un ámbito extrahospitalario por lo que se detectó la necesidad de determinar tanto el conocimiento como la aplicación de las IP en el ámbito hospitalario...
Introduction. Through advance directives (AD), a citizen can leave written medical care he wants to continue with it, if his ability to express compromised. This document is based on bioethics, in particular with respect for patient autonomy. It was traditionally paternalistic model that determined the doctor-patient relationship. Since the late twentieth century has been giving more importance to the beliefs and opinions of patients, and these were ultimately chosen, in what is call the deliberative model. The historical origin of AD is in what is called in the USA “living wills”. Regarding the legislative framework is in the Law 41/2002, regulating patient autonomy, particularly in Article 11, where these documents, which must always appear in writing are regulated. This law leaves open the specific regulations of the different autonomous communities, so in May 2005, the CAM approved Law 3/2005. There is a nationwide registry (National Registry of Advance Directives) regulated by Royal Decree 124/2007. Over the past several years studies have revealed the existence of a high level of ignorance of AD by both patients and health professionals. All these studies have been developed in an outpatient setting, so the need to determine both the knowledge and the application of AD in hospitals was detected. Objetive. To assess the level of knowledge and realization of AD on users of the Health System Madrid and the degree of information on these that give healthcare professionals working in hospital...
Introduction. Through advance directives (AD), a citizen can leave written medical care he wants to continue with it, if his ability to express compromised. This document is based on bioethics, in particular with respect for patient autonomy. It was traditionally paternalistic model that determined the doctor-patient relationship. Since the late twentieth century has been giving more importance to the beliefs and opinions of patients, and these were ultimately chosen, in what is call the deliberative model. The historical origin of AD is in what is called in the USA “living wills”. Regarding the legislative framework is in the Law 41/2002, regulating patient autonomy, particularly in Article 11, where these documents, which must always appear in writing are regulated. This law leaves open the specific regulations of the different autonomous communities, so in May 2005, the CAM approved Law 3/2005. There is a nationwide registry (National Registry of Advance Directives) regulated by Royal Decree 124/2007. Over the past several years studies have revealed the existence of a high level of ignorance of AD by both patients and health professionals. All these studies have been developed in an outpatient setting, so the need to determine both the knowledge and the application of AD in hospitals was detected. Objetive. To assess the level of knowledge and realization of AD on users of the Health System Madrid and the degree of information on these that give healthcare professionals working in hospital...
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Tesis inédita de la Universidad Complutense de Madrid, Facultad de Medicina, Departamento de Toxicología y Legislación Sanitaria, leída el 24/11/2015. Tesis formato europeo (compendio de artículos)