El documento de voluntades anticipadas como expresión del principio bioético de autonomíaun estudio empírico en los departamentos de medicina interna

Abstract

Determine the attitude of the users of the internal medicine hospital services regarding to death and the limitation of the treatments prolonging their life in a futile way. Specifical objectives Check if the studied population has received information about the existence of the living will. Quantify in the studied population, the ones having made a living will. Analyse if there is any relation between the way how the population faces death and the realization of the living will document. Methodology We made an observational, transversal, descriptive study between January and August of 2018 among the users of the internal medicine services in three hospitals belonging to the Servicio Murciano de Salud and Hospiten (Malaga) It was used a questionnaire designed ad hoc asking about the living will, the revised profile of attitudes face to death which results identify a person with an attitude of fear, avoiding, acceptation, neutral, rapprochement acceptation, escape acceptation. The introduction criterions were to be user of legal age, of the internal medicine service during the period of realization of the study, with a good mental and physical condition to fill up the questionnaire . They were excluded the users that because of their condition were not in condition to complete the questionnaire or doesn't wanted to participate in the study. They were distributed 620 questionnaires of which 392 were correctly completed, 75 were incomplete, 24 were not answered, 1 had more than one answer per question. 129 were not returned. Conclusions The results of the study conclude that the living will is barely used in the countries disposing of it, Spain not being an exception. At the beginning it was considered that the ignorance of the living will from the part of the population and the fear to death can be part of the cause why this tool is not used in a wider way. But the recollected data contradicts this argument as the 80,36% of the population were aware about it. When valuating the perspective of the people of the living will, the 95,4% refer that it's important that heir doctor inform them about this document, whilst the 81,4% considers it useful and the 90,8% believes that it makes easier the take of decisions of the family when facing the end of life of a loved one. But in spite of the population having a good concept of the living will and considers it useful, only the 36,5% has considered making a living will and the 2% of the persons has already made one. To answer the question if fear and the rejection that death causes in the society can be the reason why people does not realize a living will, the PRAM showed that despite the end of life and the suffering that can come with it causes an attitude of fear and rejection in people, the predominant attitude was the Neutral Acceptation, the end of life is considered as something inevitable that has to arrive. In relation with the people having a living will in this study, they have an attitude of avoidance, escape and fear to death, which suggests that the fear to suffering was associated to the realization of the living will.