ETHICAL AND DEONTOLOGICAL ASPECTS OF PALLIATIVE CARE IN GERIATRIC PATIENTS IN ROMANIA. CASE REPORT

Abstract

ETHICAL AND DEONTOLOGICAL ASPECTS OF PALLIATIVE CARE IN GERIATRIC PATIENTS IN ROMANIA. CASE REPORT (Abstract): We present the case of an 82-year-old female patient with a personal history of hypertension and diabetes, who presented to the emergency room for marked physical asthenia, loss of appetite and diffuse abdominal pain with onset about a week earlier. Recent history showed that she suffered a same-level fall in the past 24 hours, and was unable to get up from the floor where she had laid for several hours. On admission, the patient complained of severe diffuse osteoarticular pain that kept her in bed; she also complained of lower abdominal pain on superficial and deep palpation that proved to be a urinary tract infection. She was dehydrated and anemic (Hb=7.3 g/dL); she was depressed and very anxious to get home as quickly as possible. The therapeutic ap-proach was focused on the prompt correction and the thorough investigation of the severe anemia syndrome, the complex therapy of osteoarticular pain, and prevention of the compli-cations of immobilization syndrome. Despite patient’s wish that multiple and complex inves-tigations not to be conducted and to be discharged from the hospital and go home, the family strongly insisted to continue searching, no matter what, for the causes of anemia with the purpose of prolonging her life, but with very poor outcome on patient’s quality of life. With no specific laws concerning the respect for patient’s wishes, the medical personnel had very little to say in this matter, even if we watched the decline in her quality of life with every day she spent away from home.