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Autore principale:	Henrique de Alencar Gomes
Natura:	Artículo científico
Lingua:	pt
Pubblicazione:	Conselho Federal de Medicina 2014
Soggetti:	Filosofía Bioética Direito a morrer Tomada de decisões Cuidados paliativos Traumatismo encefálicocrônico
Accesso online:	https://www.redalyc.org/articulo.oa?id=361533265010
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Sommario:

Limitação de esforço terapêutico na pessoa com lesão encefálica grave Henrique de Alencar Gomes Mônica Adelaide Almeida Terezinha Valéria Ferreira Matoso Maria Angélica Assunção Viana Maria Bernadete Cardoso Rezende Maíza Ângela Ferreira Bento Tatiane Santos Fonseca Guimarães Sabrina Vilane de Oliveira Alcântara Ary Demétrio Júnior Ana Paula Gomes Costa Silva Cibele Renata de Paula Moreira Daniela Simplício Vieira Albergaria Marília Káthya Coutinho Marli Medeiros Roseli Melo Silva de Souza Polianna Cristina Pires Dumont Filosofía Bioética Direito a morrer Tomada de decisões Cuidados paliativos Traumatismo encefálicocrônico As discussões a respeito das condutas de limitação de esforço terapêutico (LET) são frequentes nas unidadesde terapia intensiva e na especialidade médica oncológica e são também importantes em contextos hospi-talares de internação de longa permanência para vítimas de grandes traumas e agravos que necessitam decuidados prolongados à saúde e de reinserção social. Na prática clínica, a tomada de decisão para LET é com-plexa e deve envolver o indivíduo, a família e a equipe multiprofissional. O objetivo deste artigo é discorrera respeito da LET como um abrangente processo de “adequação de medidas” por agregação consensual defatores centrado na pessoa, pautado por intensificação dos cuidados paliativos. 2014 artículo científico 1983-8042 https://www.redalyc.org/articulo.oa?id=361533265010 pt http://www.redalyc.org/revista.oa?id=3615 Revista Bioética application/pdf Conselho Federal de Medicina Revista Bioética (Brasil) Num.2 Vol.22

if (filemtime($filename) + $maxlifetime < time()) { unlink($filename); $count++; } } return $count; } /** * A function that is called internally when session data is to be saved. * * @param string $sessId The current session ID * @param string $data The session data to write * * @return bool */ protected function saveSession($sessId, $data): bool { $sessFile = $this->path . '/sess_' . $sessId; if ($handle = fopen($sessFile, 'w')) { $return = false; // Lock the file for exclusive access to avoid issues with multiple // processes writing session simultaneously: if (flock($handle, LOCK_EX)) { $return = fwrite($handle, $data); // Make sure that there's no trailing data by truncating the file to // the correct length: ftruncate($handle, strlen($data)); fflush($handle); flock($handle, LOCK_UN); } fclose($handle); if ($return !== false) { return true; } } // If we got this far, something went wrong with the file output... // It is tempting to throw an exception here, but this code is called // outside of the context of exception handling, so all we can do is // echo a message.

// Anecdotal testing Today and Yesterday seems to indicate destroy() // is called by the garbage collector and everything is good. // Something to keep in mind though. return 0; } /** * Write function that is called when session data is to be saved. * * @param string $sessId The current session ID * @param string $data The session data to write * * @return bool */ public function write($sessId, $data): bool { if ($this->writesDisabled) { return true; } return $this->saveSession($sessId, $data); } /** * A function that is called internally when session data is to be saved. * * @param string $sessId The current session ID * @param string $data The session data to write * * @return bool */ abstract protected function saveSession($sessId, $data): bool; }

* * @return void */ public function writeClose() { // The assumption is that we're using PHP's ext/session. // session_write_close() will actually overwrite $_SESSION with an // empty array on completion -- which leads to a mismatch between what // is in the storage object and $_SESSION. To get around this, we // temporarily reset $_SESSION to an array, and then re-link it to // the storage object. // // Additionally, while you _can_ write to $_SESSION following a // session_write_close() operation, no changes made to it will be // flushed to the session handler. As such, we now mark the storage // object isImmutable. $storage = $this->getStorage(); if (! $storage->isImmutable()) { $_SESSION = $storage->toArray(true); session_write_close(); $storage->fromArray($_SESSION); $storage->markImmutable(); } } /** * Attempt to set the session name * * If the session has already been started, or if the name provided fails * validation, an exception will be raised. * * @param string $name * @return SessionManager * @throws Exception\InvalidArgumentException */ public function setName($name) { if ($this->sessionExists()) { throw new Exception\InvalidArgumentException( 'Cannot set session name after a session has already started'

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Environment & details:

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Environment & details:

Environment & details: