title: [The suitability of therapeutic effort: An end-of-life strategy].
abstract: End-of-life treatment and attention to the needs of relatives are not adequate for several reasons: Society denies or hides the death; it is very difficult to predict it accurately; treatment is frequently fragmented between different specialists, and there is insufficient palliative medicine training, including communication skills. There are frequent conflicts with decisions made at the end of life, particularly the suitability of therapeutic effort. The attitude of professionals on the adequacy of therapeutic effort is not homogenous, and varies depending on the specialty, experience, and beliefs. Many doctors are still afraid of inconveniencing patients. Primary care is in a privileged position to approach the life and values of our patients and their families, and not just the disease, which makes it the right place to guide and advise the patient on the preparation and registration of living wills.
authors.affiliation: Servicio Provincial de Cádiz de Emergencias Sanitarias 061 Andalucía, Hospital Clínico de Puerto Real, Puerto Real, Cádiz, España. Electronic address: anibal.barca.221@gmail.com.
authors.forename: F M
authors.initials: FM
authors.lastname: Pérez Pérez
mesh_terms: D016223:Advance Directives / Q000941:ethics / Q000331:legislation & jurisprudence; D001291:Attitude of Health Personnel; D006801:Humans; D018447:Medical Futility / Q000941:ethics / Q000331:legislation & jurisprudence; D010166:Palliative Care / Q000941:ethics / Q000379:methods; D010358:Patient Participation / Q000331:legislation & jurisprudence; D057240:Patient Preference / Q000331:legislation & jurisprudence; D018802:Patient-Centered Care / Q000941:ethics / Q000331:legislation & jurisprudence / Q000379:methods; D011320:Primary Health Care / Q000941:ethics / Q000331:legislation & jurisprudence / Q000379:methods*; D011368:Professional-Family Relations / Q000941:ethics; D011369:Professional-Patient Relations / Q000941:ethics; D013030:Spain; D013727:Terminal Care / Q000941:ethics / Q000379:methods*
keywords: Adecuación esfuerzo terapéutico; Adequacy of therapeutic effort; Advance directives; Documento voluntades anticipadas; Family doctor; Futilidad; Futility; Médico de familia