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Respect for the wishes of the patient's pre-out - the ethical context
PLVANOVÁ, Veronika
This diploma paper ``Respecting Patient{\crq}s Needs Expressed in Advance{\crqq} is divided into a part containing theoretical ground and a practical part. The theoretical part outlines the basic principles of ethics and then moves towards patients{\crq} needs and wishes, their rights, and the issue of wishes expressed in advance. The domain of wishes expressed in advance is based on the principle of patient{\crq}s autonomy and it is laid down in the Convention on Human Rights and in biomedicine. The situation in the Czech Republic is made difficult by the fact that this domain has not been governed by laws and it does not have any tradition in the Czech environment. The practical part utilizes the method of qualitative research {--} a semi-controlled interview. First, I created short casuistries for selected patients and, afterwards, I spoke to them about individual topics. I had selected 11 questions that guided the interviews. My group of respondents consisted of patients hospitalized at oncology departments or leaving for outpatient chemotherapy in Nemocnice Jihlava (a hospital in Jihlava). I interviewed ten patients. The objective was to find out about the patients{\crq} informedness about their rights and about their options of expressing wishes during hospitalization. It was also intended to learn about the things the patients would like to decide upon and whom they would like to authorize to make decisions on their behalf should they become unable to express their wishes themselves. The research questions and the division of the general questions into three areas helped to the reach individual objectives. The first area comprised patients{\crq} rights most of the respondents were aware of. The most important ones included: telling the truth about their disease and treatment, the option to select and terminate their treatment, familiarity with medical staff. Another section dealt with wishes. Most of the patients hoped that a right approach of medical staff will reveal the patients{\crq} wishes without the necessity of expressing them. None of the selected respondents has ever thought about the issue of wishes expressed in advance. The final block contained questions dealing with the options of choosing a person representing patients in decision making. The patients frequently chose their family members (partners, children). In practice, the knowledge obtained through the research could be used for publication in specialized literature and to prepare instructional materials for patients as well as medical staff.
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