Ethical Aspects of Palliative Care in Critical Congenital Heart Disease
Keywords:
palliative care; congenital heart disease; hypoplastic left heart syndrome; ethics.Abstract
Introduction: Critical congenital heart diseases, such as hypoplastic left heart syndrome, pose complex ethical dilemmas due to their high morbidity and mortality. The decision to offer highly complex surgery or palliative care acquires a central ethical dimension. This challenge must be shared by physicians and family members, considering their cultural, religious, and social values.
Objective: To analyze the ethical aspects involved in the decision to offer palliative care instead of surgery, through a clinical case of hypoplastic left heart syndrome in a newborn.
Case report: As a result of the collective discussion of the case of a newborn diagnosed with hypoplastic left heart syndrome, it was concluded that the surgical options involved a high risk of mortality and the prognosis was uncertain; therefore, in an interview with the family, a shared decision was made to provide the patient with palliative care. The prostaglandin infusion was withdrawn as it was considered a futile treatment. The patient received care from his mother, pain relief with morphine, and supplemental oxygen until his death at five days of life.
Conclusions: In patients with critical congenital heart disease who have a poor prognosis and in whom uncertainties regarding survival predominate, the option of palliative care becomes a reasonable approach, by avoiding futile procedures and suffering for the patient.
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