Neuro-Ethical Praxis Amidst Pluralistic Value Sourcing

**51**

with it [2].

**Chapter 4**

**Abstract**

Bioethical Issues

*and Adriano Menis Ferreira*

issue and subsidies for decision-making.

**1. Introduction**

Terminality Advance Directives

*Jacqueline Resende Boaventura, Juliana Dias Reis Pessalacia,* 

*Larissa Da Silva Barcelos, Carlos Eduardo Pereira Furlani*

Advance directives (ADs) are understood as the act of deciding what care the patient wants to receive in the period before death. Preserving the patient's autonomy by choosing his care guarantees human dignity during the process of dying. In Brazil, life expectancy and supportive technologies have increased, leading to growth of the number of terminally ill patients. However, there is still no legislation regulating ADs causing legal uncertainty in health professionals. Nursing professionals have the support of the Federal Nursing Council to respect the ADs, but, because it is an issue little explored, nursing professionals do not feel safe in the use of ADs, and changes in the curricula of the undergraduate courses in nursing are extremely needed, ensuring that patients have their wishes met during the dying process. Thus, this chapter deals with bioethical and legal issues involving ADs and nursing in the Brazilian context, proposing to deepen reflection and criticism on the

**Keywords:** advance directives, right to die, palliative care, bioethics, nursing

Life in the society is shaped by a set of principles, values, and concepts that determine approval or disapproval judgments in the interpersonal relationships and actions of the individuals. In this context, ethics seeks to reflect and understand the presuppositions of morality, aimed at achieving the best result for people and society [1]. However, this concept was expanded through scientific and technological advances, emerging bioethics in the 1970s, which means "ethics of life" in the literal sense. Bioethics proposes the dialog between the biological and human sciences. In 1971, the oncologist and university professor Van Rensselaer Potter published the book *Bioethics: A Bridge to the Future*, placing bioethics as necessary to ensure human survival in the accelerated civilization development. He reported that knowledge has been acquired at a speed far greater than the capacity and ability to know what to do

and Nursing Practice in Brazil:

*Luciana Ferreira Da Silva, Ana Paula Da Silva,* 
