Dilemas bioéticos experimentados por el cuidador respiratorio durante el retiro de la ventilación mecánica en adultos al final de la vida.: Revisión integradora

Background: regarding the withdrawal of mechanical ventilation at the end of life, the literature has documented conceptual gaps in respiratory caregivers and the consequent bioethical dilemmas these professionals face. Objective: to analyze the bioethical dilemmas experienced by respiratory caregivers during withdrawal from mechanical ventilation in adults at the end of life based on an integrative review of the literature published between 2010 and 2021. Methodology: an integrative review of the literature following the guidelines by Whittemore & Knafl (2005) and Guirao Goris (2015). To analyze the information, a critical evaluation of the collected literature was carried out to identify behavioral patterns of respiratory caregivers. Results: non-communicable and chronic diseases were identified as the main clinical conditions that determine the decision-making of the respiratory caregiver in the withdrawal of palliative mechanical ventilation; artificially prolonging life in terminally ill patients was the most frequent bioethical dilemma. Conclusions: respiratory care professionals face ethical dilemmas in the withdrawal of mechanical ventilation at the end of life of patients with oncological and non-oncological conditions; decision-making is carried out mainly based on the classic bioethical principles of Respect for autonomy, Beneficence, Non-maleficence and Justice. The lack of studies on bioethics in dialogue with the guidelines of the Universal Declaration on Bioethics and Human Rights is evident. Introducción: sobre el retiro de la ventilación mecánica al final de la vida, la literatura ha documentado brechas conceptuales en los cuidadores respiratorios y los consecuentes dilemas bioéticos a los que se enfrentan estos profesionales. Objetivo: analizar los dilemas bioéticos que experimentan los cuidadores respiratorios durante el retiro de la ventilación mecánica en adultos al final de la vida a partir de una revisión integradora de la literatura publicada entre 2010 y 2021. Metodología: revisión integrativa de la literatura siguiendo los lineamientos de Whittemore & Knafl (2005) y Guirao Goris (2015). Para el análisis de la información se realizó una evaluación crítica de la literatura acopiada para identificar patrones de comportamiento de los cuidadores respiratorios. Resultados: las enfermedades no transmisibles y crónicas fueron identificadas como las principales condiciones clínicas que determinan la toma de decisiones del cuidador respirat