Universitat Internacional de Catalunya
Desire for Hastened Death and End of Life Care
Other languages of instruction: Catalan, English
Teaching staff
Introduction
The course deals with the definition, epidemiology and clinical approach to the desire to bring forward death with a holistic and interdisciplinary vision. The concept, definition and clinical characteristics of the last days situation as well as palliative sedation (definition, ethical requirements and indications) are addressed.
Pre-course requirements
It is not necessary to have taken any other subject of the master's degree, although it is advisable to have taken the subject ‘Fundamentals of palliative care and anthropology of death’.
Objectives
● To train students in the Palliative Care (PC) model based on multidimensional care through interdisciplinary teamwork.
● To provide students with the development of skills, knowledge and methods of team intervention for the adequate detection and relief of suffering through the clinical control of symptoms, emotional, social and spiritual needs in an advanced situation and their family, respectively according to their professional profile.
● To familiarise students with the appropriate management of the desire to bring forward death.
● To offer students the necessary tools to have an interdisciplinary vision of the end-of-life situation.
Competences/Learning outcomes of the degree programme
- CN05 - Acquire knowledge in the management of complex end-of-life situations including the wish to bring forward death and considering all dimensions of the patient
- CP01 - Work in a self-directed or autonomous manner in PC teams, formed by peers, specialists or not, and other professionals, respecting the fundamental rights of equality between men and women, the promotion of human rights and the values of a culture of peace and democratic values; using language that avoids androcentrism and stereotypes.
- CP03 - Independently carry out tasks in the area of PC according to the protocols established for this purpose.
- CP04 - Manage care practice by adapting it and prioritising the personalisation of care in complex and changing healthcare environments.
- CP05 - Work individually and in teams, assuming responsibilities, within the area of PC.
- CP09 - pply solutions to problems that may arise when carrying out tasks in the field of PCs.
- HB01 - Make a critical reflection on the theory and its applications in the care of the patient at the end of life
- HB03 - Integrate multidimensional care to the problems of patients in advanced illness.
Learning outcomes of the subject
On completion of the course, students will be able to:
2.1 Demonstrate an in-depth knowledge in the care of the patient with a wish to bring forward death.
2.2 Demonstrate a critical understanding of the ethical issues in end-of-life care and the wish to bring forward dying.
Syllabus
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Definition, epidemiology and characteristics of the wish to anticipate death.
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Clinical assessment of the wish to hasten death.
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Clinical responses to the wish to hasten death and euthanasia.
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Definition and characteristics of the last days situation, impact on the family and crisis situations.
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Palliative sedation: definition, ethical requirements and indications.
Bibliography and resources
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Desire to bring forward death
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An International Consensus Definition of the Wish to Hasten Death and Its Related Factors. Balaguer A et al. PLoS One. 2016 Jan 4;11(1):e0146184. doi: 10.1371/journal.pone.0146184. eCollection 2016.
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Understanding patients' experiences of the wish to hasten death: an updated and expanded systematic review and meta-ethnography. BMJ Open. 2017 Sep 29;7(9):e016659. doi: 10.1136/bmjopen-2017-016659. Andrea Rodríguez-Prat et al.
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The clinical evaluation of the wish to hasten death is not upsetting for advanced cancer patients: A cross-sectional study. Josep Porta-Sales et al. Palliat Med. 2019 Jun;33(6):570-577. doi: 10.1177/0269216318824526. Epub 2019 Jan 28.
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Situation in recent days
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Situación de últimos días. x En Manual de Control de Síntomas. Joaquim Julià-Torras y Gala Serrano-Bermúdez Editores. 4a edición. Ediciones Arán.
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Patient and Family Preferences About Place of End-of-Life Care and Death: An Umbrella Review. Pinto S et al. J Pain Symptom Manage. 2024 Jan 17:S0885-3924(24)00016-2. doi: 10.1016/j.jpainsymman.2024.01.014.
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Last Days of Life (PDQ): Health Professional Version.PDQ Supportive and Palliative Care Editorial Board. 2024 Jan 18. In: PDQ Cancer Information Summaries [Internet]. Bethesda (MD): National Cancer Institute (US); 2002–.
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Navigating and Communicating about Serious Illness and End of Life. Jackson VA, Emanuel L. N Engl J Med. 2024 Jan 4;390(1):63-69. doi: 10.1056/NEJMcp2304436. Epub 2023 Dec 20.
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Potentially inappropriate end-of-life care and its association with relatives' well-being: a systematic review. Ham L et al. Support Care Cancer. 2023 Nov 30;31(12):731. doi: 10.1007/s00520-023-08198-0.