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ISSN 2683-2348 (Electronic)
Federación Latinoamericana de Simulación Clínica y Seguridad del Paciente

2021, Number 2

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Simulación Clínica 2021; 3 (2)

Decision-making capacity, surrogates, and advance directives: a clinical simulation case

Rodríguez-Bauzá DE, Silva-Rodríguez ME, Rodgers D

Language: Spanish
References: 17
Page: 63-68
PDF size: 244.92 Kb.


ABSTRACT

The ethical principle of autonomy reflect the self-determination of patients to make decisions in health matters. In this 1-hour simulation case, patient "Y", 75-year-old male, retired elementary school teacher, with a history of lung cancer, is taken to the emergency department by his daughter due to one week history of worsening cough and pleuritic chest pain. During the last 24 hours, he has become more confused, lethargic, fatigue, and worsening respiratory distress. The patient signed an advance directive 3 months ago, which specifies "no intubation". The simulation takes place in the morning round during which the patient's condition continues to deteriorate and requires intubation. Her companion (daughter with eight months of pregnancy) expresses her wish that "her father can live long enough to see the birth of his first grandchild", she does not know about the existence of this legal document. The objectives of this simulation case allow the development of communication skills and the best course of action to resolve this ethical conflict in a safe simulated learning environment. This clinical simulation case is an experiential educational tool that can improve professional competence, confidence and collaboration of students in the performance of professional practice in accordance with the ethical principle of autonomy and self-determination of the patient.


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