Percepción de médicos intensivistas de adultos sobre el aporte de la consultoría ético-clínica / Opinion about clinical ethics consultation among intensivist physicians

Background: Clinical ethics consultation services and their methods vary and they are seldom evaluated. Only one formal system of individual clinical ethics consultation has been reported in Chile, with a ten-year registry. Aim: To evaluate the opinion of intensivist physicians about the contribution of clinical ethics consultation. Material and Methods: An anonymous and voluntary questionnaire consulting their opinion about clinical ethics consultations was sent to 38 intensivist physicians. Results: The questionnaire was answered by 28 professionals. Eighty four percent of respondents considered that ethics consultation contributed to improve patients' quality of care, 92% responded that this practice helps in decisions about limitation of treatments or life support, and 96% expressed that it also was a positive support for patients and their relatives. Seventy two percent of respondents considered that ethics consultations enhanced their ethical sensibility, 76% that they improved their understanding of clinical ethics topics, and 72% declared that it decreased their stress in complex decision-making. Conclusions: Clinical ethics consultation provides a positive support for improvements in clinical decision-making and in the quality of patients' care.

Criterios de médicos tratantes para indicar instalación de gastrostomía en pacientes con demencia avanzada / A survey about the criteria for the indication of a gastrostomy in patients with advanced dementia

Background: Decision making concerning patients with advanced dementia is complicated. The indication of a gastrostomy is among these hard decisions, especially considering that there is no consensus about its real benefit. Aim: To explore the criteria used by Chilean physicians to indicate a gastrostomy in patients with advanced dementia. Material and Methods: A questionnaire about the decision making to indicate a gastrostomy was delivered to 72 physicians working in public and private hospitals. Results: The survey was answered by 43 physicians. Fifty one percent had indicated a gastrostomy to patients with advanced dementia in the last year, 79% believed that gastrostomy reduces the risk of aspiration pneumonia, 50% thought that gastrostomy helps in bed sore healing and 74% believed that gastrostomy improves survival. Conclusions: The majority of physicians who answered the survey think that gastrostomy will improve the health status of patients with advanced dementia.