Buscar en
Toda la web
Inicio BIOETHICS UPdate A proposal for a shared care plan at the end of life: The Natural Death Protocol
Journal Information
Vol. 3. Issue 1.
Pages 45-58 (January - June 2017)
Download PDF
More article options
Vol. 3. Issue 1.
Pages 45-58 (January - June 2017)
Original article
DOI: 10.1016/j.bioet.2017.02.001
A proposal for a shared care plan at the end of life: The Natural Death Protocol
Una propuesta para un plan de cuidado compartido al final de la vida: el Protocolo de muerte natural
Vittoradolfo Tambone, Laura Leondina Campanozzi
Corresponding author

Corresponding author.
Institute of Philosophy of Scientific and Technological Practice (FAST) – Campus Bio-Medico University of Rome, Rome, Italy
Article information
Full Text
Download PDF
Tables (2)
Table 1. Core components of PS.
Table 2. Key points for a natural death protocol.
Show moreShow less

Over the last two-decade, major efforts have been underway to improve the standard of care at the end of life. Nevertheless, recent evidence has highlighted that many patients still receive overtreatment or inappropriate support to face dying in all its complexity. These scenarios may increase thoughts of death that often occur during the course of terminal illnesses requiring prompt and adequate interpretations and interventions. This suggests the need for a change in treating dying patients along with a clear understanding of the root causes of requests for euthanasia. In this regards, we propose a protocol for a shared end-of-life care plan aimed at ensuring a quality accompaniment toward natural death. It involves the patient and their family, as well as healthcare providers in a flexible work plan articulated in two phases concerning respectively pre-mortem and post-mortem actions. It offers a clear and systemic template for care in preparation for natural death, which takes into consideration healthcare duties and the patient as a person.

Terminal palliative sedation
Advanced care planning
Natural Death Protocol

Desde hace dos décadas, se han realizado muchos esfuerzos para promover el cuidado estandarizado al final de la vida. No obstante, existen evidencias recientes que señalan que muchos pacientes todavía reciben tratamiento inapropiado para enfrentar el proceso de morir en toda su complejidad. Esos escenarios aumentan los pensamientos sobre la muerte en el proceso de la enfermedad terminal lo cual requiere prontas y adecuadas interpretaciones y acciones. Ésto sugiere la necesidad de cambiar el manejo de los pacientes en proceso de muerte comprendiendo claramente las raíces del porqué solicitan eutanasia. En éste sentido, nosotros proponemos un protocolo de cuidados de fin de vida en forma compartida que asegure la calidad de acompañamiento frente a la muerte natural. Este modelo implica al paciente y la familia, así como a los proveedores de salud en un plan flexible de trabajo articulado en dos fases de acciones, la pre-mortem y la post-mortem. Este modelo ofrece una clara y sistémica base de cuidado en preparación para la muerte natural, que toma en consideración las obligaciones del personal de salud y al paciente como persona.

Palabras clave:
Sedación paliativa terminal
Plan de cuidados avanzados
Protocolo de Muerte Natural


These are the options to access the full texts of the publication BIOETHICS UPdate

If you already have your login data, please click here .

If you have forgotten your password you can you can recover it by clicking here and selecting the option “I have forgotten my password”
Subscribe to


Purchase article

Purchasing article the PDF version will be downloaded

Price 19.34 €

Purchase now
Phone for subscriptions and reporting of errors
From Monday to Friday from 9 a.m. to 6 p.m. (GMT + 1) except for the months of July and August which will be from 9 a.m. to 3 p.m.
Calls from Spain
932 415 960
Calls from outside Spain
+34 932 415 960
Article options
es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos