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Master Thesis

Un espace éthique gériatrique : bilan d'une expérience sur 7 ans (2008-2014)

Abstract : Introduction: Elderly care regularly raises complex ethical questions. Due to a growing sanitary and legal framework, it is important to tackle complex issues in geriatrics from an ethical perspective. Following the advice of the National Ethics Committee, an Ethical group was created in March 2008 in the department of gerontology of the university hospital Xavier Arnozan in Pessac affiliated to the University of Bordeaux. This Ethical group offers valuable advice in the decision-making on complex issues in geriatrics. Objective: Presentation of a progress report of the Ethical group since its creation until 2014. Method: This multidisciplinary group meets twice per month. One or two clinical cases are examined during each session. Each case is discussed collectively with the goal of elaborating proposals. Our study consisted in analyzing the set of reports of these group meetings. Results: 170 cases were presented during 161 meetings over 7 years. There were a total of 300 different participants from the following categories: doctors (46%), registered nurses (25%), nursing auxiliaries (9%), psychologists (8%) and social workers (5%). The average attendance per meeting is 12 participants. The average age of the population studied is 82 years for a sex-ratio M/F of 0.93. Amongst the 170 cases, 64 required a reassessment (38%). Each case addresses 1 or 2 issues. In total, 239 issues were raised, of which the 6 most recurrent ones were : choice of place of living (20%), continuation or suspension of food (19%), transition from curative to palliative stage (11%), refusal of healthcare/food refusal (10%), continuation/suspension of diagnosis making (8%), and continuation of active treatments (8%). Two main issues, namely choice of place of living and continuation or suspension of food, were studied thoroughly to identify the characteristics specific to each! issue (MMS, autonomy, conflict and decision-making). Conclusion: The multidisciplinarity of the Ethical group allows for an in-depth debate for complex situations. The question of the autonomy of the patient is central. The Ethical group meetings are essential in geriatrics because they help for decision-making and improve the quality of healthcare.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-01201966
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Submitted on : Friday, September 18, 2015 - 2:16:37 PM
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Guillaume Brieda. Un espace éthique gériatrique : bilan d'une expérience sur 7 ans (2008-2014). Médecine humaine et pathologie. 2015. ⟨dumas-01201966⟩

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