Toma de decisiones compartidas al final de la vida: un estudio cualitativo desde la bioética clínica

Kelvin J. Rojas Álvarez

doi:10.5294/pebi.2025.29.2.2

Authors

Kelvin J. Rojas Álvarez Author Hospital Dr. Franco Ravera Zunino https://orcid.org/0000-0002-4509-3584

DOI:

https://doi.org/10.5294/pebi.2025.29.2.2

Keywords:

Shared decision-making, palliative care, bioethics, personal autonomy, right to die, family, moral personhood

Abstract

The aim of this study was to explore how patients, caregivers, and healthcare professionals experience shared decision-making at the end of life from a clinical bioethics perspective. The study employed an exploratory qualitative design with an interpretive approach, based on semi-structured interviews conducted with patients with advanced illness, primary caregivers, and palliative care professionals. Data were analyzed using reflexive thematic analysis. Five themes emerged from the findings: clinical deterioration as a practical limit to autonomy; the family as mediator and decision-maker; the healthcare professional as translator and moral steward; clinical urgency as a barrier to deliberation; and decision-making as a process of progressive assent. In conclusion, relational autonomy and progressive assent help safeguard human dignity and legitimize complex clinical decisions at the end of life.

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