DIFFERENT ATTITUDES TOWARD THE END-OF-LIFE IN HEALTH CARE PROFESSIONALS

There are different clinical options toward the patient in the end-of-life. However, all of them come from four global attitudes: abandon, struggle, conclusion, and to keep company. Abandon is the attitude of the physician who wants nothing to do with the patient with no expectations and in whom therapeutic options are scarce. Some times abandon translates in a derivation of the patient, its care, its compromise and its responsibility to another professional. Therapeutic struggle usually means the inertia, the obsession or the obstinacy of those who do not know how to stop therapies or are not able to understand that several times more treatment does not mean more clinical benefit. The ending or conclusion attitude assume that the best way to achieve palliation is giving an exit to the patient as his sufferance will disappear only if he can escape their situation, and the only way to give him this chance is to facilitate or even to induce his death, usually at his request. Finally, to keep company is the attitude of people that do not abandon, that look for different options to palliate a and that, if needed, use proportionate means to the patient's situation and prognosis, according to Palliative Care principia.