Therapeutic obstinacy: experience in a hospice.

Abstract

The Authors, by reference to a survey of oncologic patients in advanced state as inpatients and deceased in the “Domus Salutis” Hospice in Brescia (Italy) during the three years 1994-96, address the theme of therapeutic obstinacy in the terminally ill.

The survey, comprising some 800 subject, considers the patology of the individual patients; the Authors examined in particular the overall pharmacological therapy including the proprietary medicines utilised, the transfusions, the infusions, the infusion pumps, the use of vesical catheters and central venous catheters, use of nasogastric feeding, cardiac monitoring, respirators and the effecting of reanimation procedures during the terminal phase.

Considering the ethical and deontological aspects of therapeutic obstinacy, this is distinct from so called “continuous therapeutics” and in opposition to “abstensionism therapeutics”. The aim of this project is to widen the cultural awareness in the face of such problems and the realisation in clinical practice, taking into account that the subject survey concerns one of only three existing hospices in Italy.