Limitación del esfuerzo terapéutico en Medicina Interna

  1. García Caballero, Rebeca
Supervised by:
  1. Diego Cristobal Real de Asúa Cruzat Director
  2. Benjamín Herreros Ruiz-Valdepeñas Director

Defence university: Universidad Complutense de Madrid

Fecha de defensa: 08 July 2021

  1. Fernando Bandrés Moya Chair
  2. T.R. Velasco-Sanz Secretary
  3. Jorge Francisco Gómez Cerezo Committee member
  4. Carlos Guijarro Herráiz Committee member
  5. Emilio Pintor Holguín Committee member
  1. Medicina Legal, Psiquiatría y Patología

Type: Thesis


With the technological advances of the 20th century, the idea arises that not everything that is technically possible is ethically justifiable, thus giving rise to the concept of withholding and withdrawing treatment (WH-WD). There is a great deal of confusion on the terminology within the medical community, which means that the concept of WH-WD treatment and end-of-life situations of patients are not handled correctly on many occasions. However, considering recent events, such as the approval of the Euthanasia Law, or the COVID19 pandemic, the need to know these concepts in depth has become more evident. To carry out WH-WD treatment it is necessary to follow a rigorous process in which an important step is to know the patient’s will. These actions, widely studied in multiple fields of medicine (such as Intensive Care or Geriatrics), and less so in the environment of Internal Medicine, have been seen to be carried out in multi-pathological and elderly patients. It has also been seen that they carry a significant load of moral stress on the professionals who apply them. The main hypothesis is the fact that WH-WD treatment is very frequent in Internal Medicine and that, however, internists do not know it adequately, which may lead to its management being incorrect...