Terminalidade em UTI: Dimensões emocionais e éticas do cuidado do médico intensivista

Abstract

The purpose of this article is to discuss the emotional and ethical dimensions involved in the medical care for terminally ill patients held in Intensive Care Unit (ICU). We conducted a qualitative research in which we interviewed six members of the intensivist medical staff of a medium-sized private hospital. Six theme categories emerged from the content analysis: perception of the patient in terminal condition; emotions towards death and dying; ethical conflicts; family facing terminality; communicating bad news; and the doctor-family relation in the decision making process. In this study we will present the first three categories. The results showed that death and dying are phenomena that cause uneasiness in the intensivist doctor, since he/she expects to save the life of the patient and counts with the help of advanced life support equipment. The complexity involved in the definition of t erminality, combined with advances in medical techniques - such as mechanical ventilation, hemodialysis, enteral or parenteral nutrition, among others - may favor the promotion of dysthanasia in ICU, establishing a suitable scenario for the emergence of conflicts between the family and medical staff.