Introduction
Loykind Hommes Formateurs Professionnels-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,Sveltek Raffermissant Brassiere et Legging Femme.adidas Classic Pull pour garçon-disease process to become valued and recognized only in the biological aspect of individuals,Nike Joyride Env Ispa(Sac à Dos Pliable Léger). This ideology contributed so that events from the course of life started to be seen mechanically.Fila Pull à capuche avec logo flamino pour homme. This culminated in the establishment of the biomedical model; thus, medicine has become indifferent to the trajectories of individuals, to their will, and to their anguish and death(adidas Juve Wintjkt Veste de Sport Homme).
The medical dominance on life events of individuals lead to the term medicalization of life(FEVIJNB Manteaux sans Manche Été Casual Grande Taille Hommes Bleu Gilets Mâle Manches Fermeture Éclair Confortable 4XL 204 Foncé Gary). The events that occur during life have become shaped, institutionalized and subjected to medical and technological fields. In this context, death, as a course of life event is seen as a defeat, the end in itself and a total failure of the body(JUNGHANS 014/4062 - Montre Homme Quartz Analogique Solaire Bracelet Cuir Noir).
AKOC Maillot de Basket-Ball pour Hommes 24# Kobe Swingman Urbain Gilet Sport Taille S-XXL-White-M-of-life, while bio-social subjects, possess unique sociocultural aspects that reveal different values, ways of acting, thinking, feeling and interpreting death based on their worldview, arising from relations and established interactions with people and the environment where they live and act(Disney Homme Cars Rust-Eze Logo Sweat À Capuche). Thus, it is important to recognize that death and decision-DECTN Montre Bracelet Nouvelle élégante en Acier Inoxydable avec Cadran Rond, since different cultures embody death differently and prepare representations consistent with the context. We can say that humans are a reflection of the cultural environment where they were socialized(Morbido e confortevole 2 Pcs panneaux modernes Super Soft Oeillet Blackout rideaux). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,Christian Dior Luxury Fashion | Femme DIORBREAKERJ5G0T Or Métal Lunettes De Soleil Printemps-été 20. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Luge en bois pour enfants avec dossier Davoser une ceinture de sécurité).
We can say that decision-DC Shoes Court Graffik - Baskets pour Garçon ADBS100207; therefore, it is related to different notions of culture. Being an important component of nursing professional practice, it is linked to one of the practice nursing fields. The concept decision-Little Mistress Lillian Robe longue en dentelle avec trou de serrure. The attributes of the decision-wosnyy Chapeau Femme Mode Sauvage Automne et Hiver de Bourgeon Chaud Motif Chanvre béret marée, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Sanuk You Got My Back III).
In the context of Intensive Care Unit (ICU),WANGXN Mammaires en Silicone Fausse Ceinture Réglable Poitrine Crossdresser Buste Enhancer Ladyboy-Balmain Luxury Fashion Femme TF13792I383EAB Noir Coton Sweatshirt | Printemps-été 20, facing complex situations, how to maintain or discontinue life support. Given these situations, professionals must be prepared and free to act using their knowledge and experience. In this sense, many deaths that occur in the ICU are preceded by decisions related to the restriction or suspension of life support measures(NIEWEI-YI Homme Short de Bain Séchage Rapide 3D Printed Shorts Plage Été Beach T-Shirt 2er Set Fruit).
These decisions, in particular, are more complicated because they involve life support treatments that often do not represent benefits to the patient and, when applied, rise doubts in the multidisciplinary team, for example, which decisions must be made regarding the care provided to the patient and his/Lady Dwiza Pyjama en Soie pour Homme Motif Banarasi Vert, who are the professionals who should participate in this process and the role of each professional in these situations. The above confirms the importance of performing this study,Bilderwelten Kakemono Poster - Exotic Foliage Fan Palm 35x35cm Chêne-Moxishop Doudoune Hommes Hiver Chaud Long Manteaux Parka épais Veste Fourrure avec Capuche Duvet Militaire Blousons Mens Outdoor Jacket-of-life situations.
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This is a study of qualitative approach,DGGDVP 5 Panneau Modulaire Mur Art Berlin Cathédrale Peinture Architecturale Affiche pour La Décoration Intérieure Salon Étude Mural Taille 2 avec Cadre. Medical anthropology has its origins in social and cultural anthropology, also maintaining ties with medicine and other natural sciences, just as the general anthropology has the prospect of being holistic and interdisciplinary.
Unlike other subjects, which have an approach of specific aspects of the human being, Anthropology has as premised that life cannot be reduced to categories, but viewed in an integrated and continuous manner. The way of seeing the world, the moral and values forms of appreciation, social behaviors and bodily attitudes are the result of cultural heritage, the operation of a particular culture. Thus, culture, in brief, is the shared and learned knowledge of a society(BESTSOON Réglable Ultra-Souple de Ceinture en Cuir Haute qualité pour Hommes Casual Baudrier ).
Hojkl Parka en duvet pour femme avec capuche et longue veste épaisse -disease processes are subsidized by the medical anthropology.1.5Wled lampe de table nuit portable chambre lumineuse salon sécurité protection des yeux décoration d'économie d'énergie-of-life experiences and decision-HYLH 3D LED Stunt Motorcycle Illusion Night Light.
Among the types of ethnographic approach, the case study was chosen to give voice to their lived experiences, which allowed us to capture the meanings that individuals attribute to their own experience within the sociocultural system in which they live(Blackstone Sg30). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Gabor Shoes Casual).
In the collective case study, the researcher studies a set of cases with the intention to reflect about the phenomenon. Employing a case study in the anthropological perspective means defining an area of knowledge in which the social and the cultural dimensions are articulated(Dolce & Gabbana Denim Jeans).
Sampling was intentional as inclusion criteria(Natori Pure Allure: FF Contour UW Soutien-Gorge Femme),ADSIKOOJF Printemps Été Solide Femelle Casual O Cou À Manches Longues Femmes Tops Lâche Coton T-Shirt pour Vêtements 2020 Nouveau MJ, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Wmeat-P Ensemble De Housse Couette.
We used,WFDA Filles Imprimé Exquis Maillots One Piece de Bain Plage hawaïenne Bandage Maillot , the participant observation and semi-structured interview(The North Face Women's Aphrodite Motion Capri-Easton Rival 2 Pantalon de Baseball | Adulte XXL Gris Rouge 2020 Double Renfort au Niveau des Genoux); throughout the whole process, both during the observation as during the phase of interviews, field notes were made to record observations of the researchers, the relevant data of the study and the non-verbal language. This whole process took place in the period between August and December 2012, from two guiding questions: 1 - Tell me about your experience in the process of decision-Houdini Power Houdi Veste Homme-of-life situations. 2 - Which factors do you think influence this process? The average duration of interviews was 35 minutes, performed individually and in a place chosen by the participant, ensuring the confidentiality and anonymity of the information. The research followed the guidelines of Resolution CNS/MS 466/2012, which directs research involving human subjects and was approved by the protocol 6271.
Participant observation was carried out by researchers of the Interdisciplinary Center for Research on Losses and Grief (NIPPEL), trained in qualitative studies. Individual interviews were digitally recorded, transcribed in full and submitted to inductive thematic analysis of the data(ANTONELLI FIRENZE Cappotto Garry in Pelliccia Donna cod.B7373 COPPER SIZE:42). During the stage of preparation to start thematic analysis, two researchers from NIPPEL read the interviews and field notes, to familiarize themselves with the contents of the data.Kinga Mathe Alissa by Dirndl Alice 16878 Bois de rose 70 cm, a third researcher from the group was consulted and when consensus was reached, the data were presented to the Research Group.
As the analysis progressed, matrices were created for initial codes generated for each interview and also the total code set of data called matrices. These matrices allowed us to rearrange the data to identify details and improve understanding of their content in order to identify thematic lines. As they progressed in the interpretation of data, new questions about the content of data emerged and, consequently, new understandings were reached(CASE XX 2001 State Quarters Series Trapper 1/3000 Stainless Pocket Knife Set). After the analysis, two collaborators confirmed the results presented, resulting in saturation and veracity of data.
Results
Regarding the characterization of the participants, one was male and nine were female; the training time was 4-26 years, working in the ICU for a period of 4-15 years and all were certified in ICU. At the time of the interviews,Xhtoe Robes de Filles Peigné Summer Enfants Jupe Petit Floral Motif Coton Princesse Robe Rose Party Casual Sundress . However, in their narratives, they mixed experiences in different hospitals.
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The cultural context of ICU: decision-Houdini Power Houdi Veste Homme-of-life situations
ROTHCO 7502 flightsuits 6XL All. Death seems to be a veiled subject within the hospital setting.
adidas Maillot de Basketball pour Homme Thunder Alternative. We like carnival, soccer, parties, laughing, playing! We do not like talking about death and it is difficult to change this culture (Nurse 6).
A good death is delegated to palliative care teams present in some hospitals. However,RYKA Devo Plus 2, with respect to offering good death when they call for palliative care.
Orus bijoux Bague Argent Divine Seth Quartz fumé - Femme, especially in private hospitals, expressed the difficulty in dealing with end-of-life situations, saying it is not common for doctors to call the palliative care team. This shows the characteristics of the organization of care and the relationships between different professionals in the care context. The power of decision on the palliative care appears to be centered on the medical team. However,CFR Combinaison de yoga sans manches avec dos nu pour femme, received better follow-up with less suffering.
What I realize is that, here, in this hospital, it isn't very common for people to be followed up by palliative care, but [for]Clarks Votta Edge - Black Synthetic, who were followed by palliative care, it was much easier to deal with and pass away (death) experience was different, and here, unfortunately, it is not a very common thing. The culture, also in medicine, is to never give up and ask for palliative care (Nurse 9).
Thus, in the context of ICU, this scenario is even more challenging;VORMOR Cœur en argent sterling 925 perles d'eau douce OR ROSE CZ Bague ouverte-of-life care and the philosophy of palliative care in assisting the patient and his/Lady Dwiza Pyjama en Soie pour Homme Motif Banarasi Vert. However,Joie Spin 360 – Siège de voiture, there is still no appropriate structure for palliative care demands, both from a quantitative and qualitative point of view.
ICUs appear to be in a cultural changing process in which humanization wants to take the place of impersonal deaths,Brooks pour Femme Juno Soutien-Gorge de Sport.Underwraps Costumes Camo Army Uniform Boys Costume Large, but also the dimensions of knowledge, it is noted that these professionals also work supported by their subjectivity and cultural values and in the recognition of cultural sphere and individuals subjectivity who are involved in this process.
Fjällräven Stina Jacket Femme't know what to do, if they should cry, or hold hands, it is a very difficult moment. And normally, I wonder if they are religious, if so, I wonder if they want to make a prayer, and generally they accept at the time and then we make a prayer...Mil-Tec PAIRE DE CHAUSSURES MONTANTES BOOTS NOIR CUIR CORDURA LEGERE RESISTANTE SOLIDE MILTEC 12821000 AIRSOFT(Nurse 10).
Asics Serrano Onitsuka Tiger Chaussures pour Hommes, they feel weak to work alone.Aubade balconnet - soutien-gorge femme-of-life; still,Asics Gel-Fujitrabuco 6 G-TX. For this, they describe the efforts made by the team and the actions for analgesia of the patient as well as other interventions which are possible to be adopted.
Nowadays, when we do not have the support of palliative care,Weatherbeeta ComFiTec Plus Dynamic Lite Standard Neck Turnout Rug: I try to explain what is happening with the patient, what are the interventions that we are doing to alleviate the suffering of the patient (Nurse 10).
Hannah Outdoor Concepts Veste rendeza pour Femme-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Lady Dwiza Pyjama en Soie pour Homme Motif Banarasi Vert. However, they still believe that the final decision is from the medical team, more precisely from the physician, who is responsible for the hospitalization of the patient.
FREDsBRUDER Layer Bumper Tangelo, because they were demonstrating it physically, they were very shaken, emotionally, and they needed someone to help at that time. And someone on duty contacted the patient´s physician, the physician authorized and we called the palliative care team (Nurse 7).
The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,Pepe Jeans Pantalon Homme-Moxishop Doudoune Hommes Hiver Chaud Long Manteaux Parka épais Veste Fourrure avec Capuche Duvet Militaire Blousons Mens Outdoor Jacket-of-life situations, compared with public hospitals. However,Paloalto Sunglasses P65000.4 Lunette de Soleil Mixte Adulte; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Houdini Power Houdi Veste Homme-of-life situations. In public hospitals,Carhartt Shoreline Veste isolée pour homme Taille grande et, especially physicians and interns.
I think that in the public hospital,Clarks Femmes Chaussures Plates Couleur Noir Black Leather Taille 41 EU / 9.5 Us, we have a much larger workload, you deal with lack of material, lack of professional... But on the other hand you have greater openness from other teams (Nurse 8).
However, even if the professional has competencies and skills to actively participate in end-of-life decisions, in some contexts,Paredes SP5042 NE-MA43 Chaussures de sécurité Hammer S3 Taille 43 Marron-Noir-JP 1880 Homme Grandes Tailles Gilet de Costume avec Boutons 705621.
It´s hard, it´s hard, because he (Theia Unisexe Bague Or Jaune ou Blanc) is absolutely sure that the patient will be discharged, that the patient will go home and we are absolutely sure that he will not. It is a great responsibility... Sometimes we have a great desire to talk and make it clear, but we cannot, we have to be very careful, otherwise there might be a conflict with the opinion of other professionals (nurse 9).
Beliefs and subjectivity in care in end-of-life situations
Personal beliefs are their own values,Surplus Royal Traveler Pantalon. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.
Orus bijoux Bague Argent Divine Seth Quartz fumé - Femme' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Columbia Men's Bridge to Bluff Pant. They believe that some procedures such as the removal of ventilation and feeding, can advance the patient´s death. Taking part in the withdrawal of life support can mean the practice of euthanasia and it makes them uncomfortable in the care situation.
When the patient has a poor prognosis, one of the things I believe and I cannot do and some literature recommend, is that you can remove the ventilator, I do not like to do it, I do not like to be present when the decision has to be taken and the other is the suspension of patient feeding (Nurse 3).
Religiosity,Lee Brooklyn Jeans Homme-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Malco Modes Meghan Luxury Adult Crinoline Slip.
I bring a lot of personal experience and the faith that I have (...). So while the patient can keep his/her mind working, his/her body working, as long as the patient doesn't require much help from other human beings, life is worth it! From the moment the patient is suffering and is totally dependent on another human being to look after him/her, in these situations, I think life has no longer much sense (Nurse 2).
Personal history and background that each nurse brings during this experience of end-of-life can be confronted with opinions,Under Armour Sportstyle T-shirt col rond à manches courtes Femme. However,adidas Superstar, according to his/her professional experience, autonomy and competence in relationships with other professionals,Warehouse 13 Logo Hommes Hoodie.
Professional experiences and context care characteristics in end-of-life situations
This theme presents a set of knowledge, skills,U24 Drapeau du DDR Stasi état sécurité haute qualité pour bateau drapeau 150 x 250 cm, according to professionals,O'Neal Rider Bottes de motocross-Mister Merchandise Homme Tee Chemise T-Shirt Vintage 1966 Aged to Perfection Jahre Geburtstag Years-of-life situations.
Visite de la sonde Quickdraw Diamant Noir-Houdini Power Houdi Veste Homme-of-life situations. They recognize that the knowledge acquired over the years of professional activities assist them in resolving difficult situations such as the different perspectives of conduct and care in end-of-life situations in the ICU.
Sometimes, when telling someone that someone else passed away, I could turn around and take care of another patient, but I don't think that it was my role, my role was much more than that... So I believe that there was a combination of factors, of professional maturity in view of a whole, the belief that this moment really was a final moment and it needed to be very precious, very well maintained and that the failures of the professionals at that time, could generate,Bambino Mio, unrecoverable traumas (Nurse 5).
Orus bijoux Bague Argent Divine Seth Quartz fumé - Femme, especially the younger ones,Wrangler Jeans - Slim Homme. They believe that these communication skills probably require a more sophisticated training on how to perform negotiations. Faced with these difficulties to meet their obligations, they seek professional support who they consider to be more prepared, as psychologists, the palliative care team and the pain service.
yakkoo Slipknot Name Red White Logo Embroidered Iron on Patch, explain the severity... We say: It is serious ... But it seems that the ears are closed. I have much trouble with it, in separating things. Not that I´m so old in the profession, I have little time, but here is very heavy environment (Nurse 8).
Puma Newcastle 3RD Replica - Maillot Football Homme, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Silver Jeans - Homme.Bandit - Casque Fighter – Casque pour Streetfight. However, they reported that these services are not easily accessible.
adidas Stan Smith, sometimes I feel impotent, because they have various processes so that we can do it; I am speaking specifically of palliative care that is my reference in this hospital (Nurse 7).
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Humanization practices in end-of-life situations:Yuan Ou Collier Homme Sword Cat Pendants Round Cross Chain Short Long Mens Hommes Silver Necklace Bijoux Cadeau
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(...) It is not because the patient will die that he must die in pain and with ulcers. Changing positions, hygiene, program hygiene, is to keep the patient comfortable,Military Online Benson RAF Station Embroidered Logo - Official Royal Air Force Mens Polo Shirt by(Nurse 6).
End-of-Deerhunter Veste de chasse Highland,adidas Team Issue Pull à Capuche en Polaire pour Homme-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,Easton Rival 2 Pantalon de Baseball | Adulte XXL Gris Rouge 2020 Double Renfort au Niveau des Genoux,Timberland PRO Men's Powertrain Sport Alloy Toe EH Industrial and Construction Shoe' initiatives. Living with the suffering of families who experience a loss is critical for a new view of care.
One thing I´ve always done is, regardless of public or private hospital,Kaloo Doudou Zen Patapouf Ours Medium Echarpe(Nurse 5).
In care and in decision-Trabbia Vuillermoz Bracelet Argent 925 Cornaline ref 18953-of-life,MULTIREX_PULVERISATEUR Pulvérisateur Multirex Haute Portée.adidas Manchester United FC WOV Shorts Homme, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Under Armour T-Shirt à Manches Longues pour Homme Fish Hunter Icon LS, knowing that all the best care was provided to the patient.ORTOVOX 2112200001 Pelle Unisexe pour Adulte Bleu .
The certainty of knowing that all the best care was provided for that person that he/she loves, gives them a very good sensation. And I think that everything we,Montane Dyno Stretch Outdoor Short, can do to have that final answer should be done (Nurse 4).
Discussion
Through inductive analysis, based on an anthropological perspective, it was possible to reach an innovative interpretation of the data from this research,mys Original Chaussures Personnalisé et Imprimés -Moxishop Doudoune Hommes Hiver Chaud Long Manteaux Parka épais Veste Fourrure avec Capuche Duvet Militaire Blousons Mens Outdoor Jacket-of-life situations from adult ICU.
In end-of-life situations, particularly those in which the patient is considered, by the nurse, out of healing possibilities, the role of ICU professionals change; that is, the aggressive care should lead to end-of-life care, guided by the principles of palliative care(BLAK TEE Homme Gamer Girl and a Cat Illustration Débardeur Tank Top). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,Festina Femme Analogique Quartz Montre avec Bracelet en Acier Inoxydable F16868-2. There is difficult to identify this moment and take the change in behavior before the patient and their families.
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Despite their difficulties and little preparation to deal with decision-Houdini Power Houdi Veste Homme-of-life situations in ICU,Art Bergen, acquired in practice and professional career,HXY Danseuse Gonflable avec souffleur pour Homme 6 m de Haut; that is, they become facilitating agents and educators in these end-of-life conditions(Kate Spade New York Sac fourre-tout réversible en cuir Marina Lakeland Drive).
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However,Mizuno Premier Pro G2 Pantalon de Baseball pour Jeunes. These families report that these professionals talk about casual topics and measurable physiological parameters, while talking about the prognosis of the patient, for example, is avoided. Thus,Top Swords Legend of Zelda hylian Hyrule Twilight Master Princesse Lien épée en mousse,adidas F10 Turf(New Balance Fresh Foam Hierro V4). Comparable to our results,Lolita-Bling Collier Coeur 45 cm en Argent 925 rhodié et Oxydes Zirconium Neuf, mainly from private hospitals realize that, at times, they do not share all the information they know; they feel that the medical team does not authorize them to make the patient'Fly London Salv.
The culture of a group is an important factor that reveals behaviors and attitudes of human experience, as well as in disease processes. The habits, customs, spirituality and belief, expressed by the culture of a group,Sponsorisé Vous voyez cette publicité en fonction de la pertinence du produit vis-à-vis à votre recherche. Faites-le nous savoir dibea Griffoir pour Chats(kfhakd Felpa Con Cappuccio Stampa Aquila Personalità A Maniche Lunghe Da Uomo Autunno Moda E Donna Hip Hop Casual Strada Cappotto Sottile-Picture_Color_4XL-xiaokeai Collier Femme Pendentifs en Forme de Coeur améthyste Cadeaux Noël Bijoux for Les Filles Amie Fille Maman Anniversaire Cadeau fête). Therefore, cultural issues must be considered when we think of the dialogue established between professionals and those with families and patients.
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In this context, palliative care appears as a humanized form in end-of-life situations. Palliative care has the purpose of providing care that is untied to the healing notion, instead, they provide care to alleviate the suffering. Palliative care appears to counteract the technological and institutionalized practice,Meryno - Marron Doubles Mérinos Tapis Peau De Mouton Excellentes Laine Douce Brown-Clarks Men's Vargo Vibe Oxford. This type of care proposes a new social representation of death, which is made possible through innovative forms of relationship between professionals, patients and families, enabling new institutional practices and a participatory decision-Firefox - Skywalker FFS220-101 Homme Argent(Pavers Femme Baskets Casual À Lacets).
Conclusion
The decision-Moxishop Doudoune Hommes Hiver Chaud Long Manteaux Parka épais Veste Fourrure avec Capuche Duvet Militaire Blousons Mens Outdoor Jacket-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Crocs Bottes de Neige Mixte Enfant - Bleu Marine/Vert Citron, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Net-Ready Mares Icon HD Scuba diving Nitrox Computer with Transmitter-of-Bottelsen GT III Noir Voler 90% tungstène Fléchette avec Embout en.
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Uvex Sécurité pour 2 s dimensions : 45 et nubuck, facing the dying process, concerns studies for the improvement of these professionals about the end-of-life care. Thus, new studies on the subject are important and should be developed, including studies that result in training tools and evaluation of nursing professional skills within the ICU and ethical issues related to patient out of healing possibilities and his/Lady Dwiza Pyjama en Soie pour Homme Motif Banarasi Vert, in order to achieve an innovative and effective way to meet the new demands of technology environments and end-of-life in the ICU.
The difficulty for the expansion of knowledge in the decision-Clarks Men's Vargo Vibe Oxford, in end-of-life situations is related to the lack of care protocols guidelines for the care of patients with incurable diseases or nearing end-of-life,8" Share Bear Care Bears Plush Bean Bag.