Abstract

ANGORA MAZUECOS, Francisco. Early Wills vs. Previous Instructions or Living Wills in Primary Care. Rev Clin Med Fam [online]. 2008, vol.2, n.5, pp.210-215. ISSN 2386-8201.

Hypothesis and objective. The legal system recognizes the fundamental rights of terminal patients or dying ones who can use a Declaration of Early Wills (DEW), that corresponds to a certified planning of treatments which respects the system of personal values of the patient, who can decide to die with dignity. However, a free choice requires clinical information about the possible options available. Nowadays, the reason why few people use DEW is that most of the legally required conditions are not fulfilled. The main objective here is to find information about the prolongation of life, legal and moral right to die with dignity, limitation of therapeutic effort (LTE) and the possibility of using DEW in Castilla-La Mancha. Design. Study of primary intervention using a consecutive sample of patients over 65, from a PC setting, using "an informative course that gives an introduction to the EW" and "a survey of knowledge and opinions about EW", before and after the course. Setting. Urban Health Centre of Ciudad Real. Main Variables. Socio-demographic variables (age, gender, house, cohabitation, main job before retirement). Knowledge about and impressions of EW and DEW, before and after the course. Main findings. The vast majority live in their own houses, have elementary studies and worked as housewives, civil servants, technicians or unskilled labourers. Before the session, 60% did not know anything about EW and the possibility of declaring them. People participating in the survey, and relatives, would feel more reassured if they could declare EW. They would like to register their preferences in their PC records. After the course, the vast majority have a better understanding of the legal, professional and moral limitations of the EW. A total of 70% would sign DEW before civil servants of the EW registry (Health office). Conclusion. Individuals have little information about EW at present. Staff from PC are the most suitable people to inform patients about them and should give the patients a real freedom of choice. This study should be broadened to include people of different ages.

Keywords : Advance Directives; Primary Health Care.

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