The PhD, defended by Ana María Martínez Fernández at the University of the Basque Country, proposes a series of recommendations that contribute to improving clinical and care tasks of the professionals who treat terminal cancer patients.
Autonomy is the capacity to take decisions and undertake activities when armed with knowledge about the causes of the illness, sufficient information thereof and in the absence of duress, either internal or external. With autonomy we express our system of values and what is good for each patient is decided. The more chronic the illness of patients and the more their treatment is under question, the more autonomy is called for; this becoming greater the more information is available.
The problems that usually arise in Palliative Care, besides those typically involving care arising from the pathology in question and its medical-biological complications, are informative-communicational ones, assignation of resources and everything related to the life-death binomial. It is these factors where the level of autonomy of the patient is crucial and involving decision-making.
This is the theme of the doctoral thesis that Ana María Martínez Fernández defended at the Faculty of Medicine and Odontology at the University of the Basque Country (UPV/EHU). The research involved the study of factors influencing the development of the autonomy of the cancer patient in a clinically terminal situation, proposed a series of recommendations that contribute to improving the clinical and care tasks of the professionals who are involved with terminal cancer patients.
The PhD entitled, Factores que influyen y recomendaciones que mejoran la autonoía del paciente oncológico en situación clínica terminal (Influencing factors and recommendations that enhance the autonomy of cancer patients in clinically terminal situations), was led by the Professor of the Department of Medicine, Daniel Solano López, and received excellent cum laude.
Ana María Martínez Fernández is a graduate in Medicine from the University of the Basque Country and currently is the domiciliary Palliative Care team doctor for the Spanish Association Against Cancer in area V of Madrid.
The quest for autonomy
The objective of this research, on the one hand, was to study – using the monitoring system of terminal cancer patients - the principle of autonomy of these patients: knowing their initial situation, comparing their evolution and analysing the conditioning factors and in which the doctor intervenes directly; also knowing the degree of information about their pathology and any personal factors that also have an influence on them and, finally, knowing the attitude of the people around them. On the other hand, justifiable alternatives were put forward that help in solving any problems detected.
To this end, 126 of the 164 patients attending from January 2003 to June 2004 were studied by the Domiciliary Care Team for Terminal Cancer Patients of the Spanish Association Against Cancer (AECC) in area V of Madrid.