Bioethical perspectives and principles in the care of patients undergoing tracheostomy

Abstract

Purpose: Analyse through a literature review the level of evidence of the bioethical perspectives and principles that govern the various conditions that indicate the performance of tracheostomy by health professionals. Methods: This is a systematic literature review. The search used the following descriptors, available in MesH and DeCS, portuguese, english and Spanish: “Tracheostomy”, “Medical Ethics” and “Bioethics”. The MEDLINE (Medical Literature Analysis and Retrieval Sistem online), Lilacs (Latin-American Literature in Health Sciences), Cochrane Library and IBECS (Índice Bibliográfico Español en Ciencias de la Salud) were consulted. For the search in databases, the following strategy was used: (“Traqueostomia” OR “Tracheostomy” OR “Traqueostomía”) AND (“Ética Médica” OR “Medical Ethics”) AND (“Bioética” OR “Bioethics”). The articles were categorized according to the level of evidence described in the manuscript. Results: After applying inclusion and exclusion criteria, only 38 scientific papers published until 2020 were initially found. Of the 38 articles listed, six were found in MEDLINE, five in LILACS, 25 in Cochrane Library and two in the IBECS platform. Of these, the following were excluded: one duplicate, 26 after analyzing the title and level of evidence, and six after reading the abstracts. After Reading in full, five articles were selected, which discussed bioethical concepts and principles with regard to the guidance of health professionals about indications and performance of tracheostomies in patients. Conclusion: Tracheostomy, although quite common in the practice of health professionals, requires attention to the bioethical perspectives and principles, which sometimes have not been considered. This assistance must be individualized, clarifying information to the patient and prioritizing their autonomy.