Bioethics in palliative care: technical interventions and justice for terminal patients under Kolcaba’s Comfort Theory

Abstract

This study analyzed bioethics in palliative care through Katharine Kolcaba’s Comfort Theory in order to deepen the dilemmas that arose between advanced technical interventions and justice for terminal patients. A theoretical-analytical documentary study was developed through an orienting consultation of indexed scientific literature and normative documents from the World Health Organization, the International Council of Nurses, and the World Medical Association, which were later examined by means of critical content analysis. The study showed that technological prolongation of life did not always translate into well-being, because therapeutic obstinacy, insufficient communication, limited advance care planning, and inequitable access to palliative services favored disproportionate decisions that increased suffering. It was also identified that Comfort Theory made it possible to integrate the physical, psychospiritual, sociocultural, and environmental dimensions of care in order to assess the proportionality of each intervention more accurately. It was concluded that justice for terminal patients required clinically prudent decisions, interdisciplinary ethical deliberation, honest communication with patients and families, and a humanized nursing practice capable of subordinating technology to relief, dignity, and overall well-being at the end of life.