Aspetti etici e giuridici nelle insufficienze croniche d’organo “end-stage”. Documento di consenso per una pianificazione condivisa delle scelte di cura

The specific target of an experts panel was to as- sess in terms of law and ethics the compliance of a new spe- cific decision making algorithm described in the position pa- per proposed by the Gruppo di Lavoro Insufficienze Croniche d’Organo, with the main goal of the position paper consist- ing in the shared care planning process. The following specif- ic aspects were assessed by the experts: a) the impact on case law and statute law of a new clinical pathway shared by sci- entific societies in light of good clinical practice and scientif- ic evidence; b) the relevance of all tools useful to identify the appropriateness of care pathways, recognizing responsibili- ties and decision-making skills related to the end of life choic- es made by all stakeholders involved (healthcare profession- als, patients and their beloved ones); c) the consistency of the healthcare professionals duties proposed in the position pa- per with the Italian legal order; d) the opportunity to take in- to account the role of all healthcare providers involved in care relationship; e) the consistency of the definition of patient rights at the end of life as proposed in the position paper with the Italian legal order and the relevance in this context of si- multaneous palliative care; f) the relevance of shared care planning and its consistency with the proposed operative tools; g) the relevance of the conscientious objection issue and the compliance of management tools proposed in the position paper with the results of ethical and legal consider- ations; h) considerations about available resources allocation.