From fate to tragedy : The changing meanings of life, death, and AIDS.
The advent of highly active antiretroviral therapy (HAART) and quantitative viral load assays has revolutionized the care of HIV-infected patients.
However, this paradigm shift has also had unexpected, sometimes adverse consequences that are not always obvious.
Before antiretroviral therapy, physicians learned how to accompany patients through their illness ; to bear witness to sickness and dying ; and to help patients and their families with suffering, closure, and legacy.
Since we have become better at treating the virus, a new temptation has emerged to dwell on quantitative aspects of HIV management and monitoring, although the skills that we learned earlier in the epidemic are no less necessary for providing good care.
Our newfound therapeutic capabilities should not distract us from the sometimes more difficult and necessary task of simply « being there » for patients for whom HAART is no longer effective.
The definition and practice of end-of-life care for patients with AIDS will continue to evolve as AIDS comes to resemble other chronic, treatable, but ultimately fatal illnesses, such as end-stage pulmonary disease and metastatic cancer, in which clinicians must continually readdress with their patients the balance of curative and palliative interventions as the disease process unfolds over time. (...)
Mots-clés Pascal : SIDA, Virose, Infection, Virus immunodéficience humaine, Lentivirus, Retroviridae, Virus, Relation médecin malade, Soin palliatif, Qualité vie, Facteur risque, Aspect philosophique, Homme, Mort, Immunopathologie, Immunodéficit, (HAART) highly active antiretroviral therapy
Mots-clés Pascal anglais : AIDS, Viral disease, Infection, Human immunodeficiency virus, Lentivirus, Retroviridae, Virus, Physician patient relation, Palliative care, Quality of life, Risk factor, Philosophical aspect, Human, Death, Immunopathology, Immune deficiency
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0019409
Code Inist : 002B05C02D. Création : 31/05/1999.