A bioética é uma ciência que surgiu no início da década de 1970 nos Estados Unidos, com objetivo de criar uma ponte entre a ciência biológica e a área dos valores. No Brasil, a bioética chega, efetivamente, em 1995, a partir da fundação da Sociedade Brasileira de Bioética e da promulgação da Resolução 196/96 do Conselho Nacional de Saúde, que regulamenta a pesquisa com seres humanos no país. A bioética possui vários modelos e dentre eles está o Personalismo Ontologicamente Fundado, criado por Elio Sgreccia. Esta linha de pensamento se funda na pessoa humana, ou seja, a pessoa deve ser o critério de avaliação frente a um dilema bioético. Toda pessoa humana é unitotalidade, dotada de uma dignidade. Ela é formada pelas dimensões física, psíquica, social, moral e espiritual. Este modelo considera que toda vida humana tem início com a fecundação e fim com a morte natural. Mas este conceito de pessoa humana não é o único no âmbito da bioética. Por isso, no presente trabalho, se pretendeu através da hermenêutica de Gadamer, identificar o conceito de pessoa humana utilizado no Brasil. Foram recolhidas 63 referências no site da Bireme através de palavras-chave identificadas na revisão da literatura. Destas referências, 50 foram lidas na íntegra e algumas categorias foram criadas para dividi-las, sendo elas: Início da vida, Final da vida, Prática da Saúde, Saúde Pública e Temas Variados. Os textos foram resumidos e interpretados com o objetivo de se identificarem aspectos relativos ao conceito de pessoa humana. Na discussão, os aspectos referentes ao Personalismo Ontologicamente Fundado foram evidenciados como contraponto de conceitos de outros modelos. E o critério utilizado no sentido de reconhecer o conceito de pessoa humana foi a experiência elementar, entendida como a experiência que cada pessoa faz, a partir de um critério de juízo, e através da correspondência com sua realidade. No Brasil, em relação ao Início da vida, os pesquisadores em sua maioria, consideram que a vida tem início em qualquer momento posterior à fecundação; diferentemente do conceito da bioética personalista que determina o início da vida na fecundação. Em relação ao final da vida, os conceitos de dividem, sendo que metade pensa na morte natural, e metade pensa que a pessoa deve ter autonomia para decidir pelo final de sua vida. Os que falam em morte natural, admitem os cuidados paliativos como saída para os doentes incuráveis se verem acolhidos em seu sofrimento, como diz também o personalismo ontologicamente fundado. Em relação à prática à saúde, a autonomia aparece predominantemente como auxiliar à prática médica, mas em alguns artigos este princípio aparece como a parte da pessoa de maior importância na relação paciente - equipe de saúde. De acordo com a bioética personalista o critério último frente à prática clínica deve ser SEMPRE a pessoa humana. Na saúde pública foram evidentes os aspectos relacionados à grupos vulneráveis e à necessidade de intervenção do Estado, tendo faltado a ênfase ao protagonismo da pessoa, da sociabilidade e da subsidiariedade. E no que tange a eugenia, os autores falaram em tolerância à ela e respeito à vontade da maioria da sociedade, enquanto a bioética personalista fala em considerar o diferente, o diverso, através do reconhecimentos de sua dignidade humana. Assim, no Brasil os conceitos relacionados à definição de pessoa humana são bastante diversos. Concluindo, é preciso fazer com que a comunidade bioética brasileira comece a considerar o conceito de pessoa do personalismo ontologicamente fundado, a partir do olhar para sua própria experiência, tendo como critério de juízo sua própria realidade. E utilizar essa experiência de pessoa nos momentos em que seja necessário decidir sobre as intervenções que se faz sobre a vida. / Bioethics is a science that emerged in the beginning of the 70s in the U.S. by aiming at creating a new connection between biologic science and values. Bioethics effectively arrived in Brazil in 1995 as of the foundation of the Sociedade Brasileira de Bioética [Brazilian Bioethics Society] and the publication of Decree 196/96 by the National Health Council, which rules over research with human beings in the country. Bioethics presents several models, wherein the Ontologically Based Personalism as created by Elio Sgreccia can be found. This train of thought is based on the human person, i.e. the person needs to be the assessment criteria before a bioethical dilemma. Every human person is a unitotality who is endowed with dignity. She is formed by physical, psychic, social, moral and spiritual dimensions. This model considers that all forms of human life begin upon conception and end with natural death. But this human person concept is not the only one within the bioethical scope. Thus, we intended to identify herein the human person concept used in Brazil through Gadamer\'s hermeneutics. 63 references from the Bireme website were collected through key-words identified in the revision of the literature. From among them, 50 were read completely and some categories were created so as to divide them, namely being: Beginning of Life, End of Life, Practicing Health, Public Health and Various Subjects. The texts were summarized and interpreted by aiming at identifying aspects concerning the human person concept. Aspects regarding the Ontologically Based Personalism were evinced as counterpoint to the concepts from other models within the discussions, and the criteria used to recognize the human person concept was the elementary experience that is understood as the one each person undergoes as of judgment criteria, as well as through the correspondence to its reality. In Brazil, most researchers consider life begins at any moment after conception when referring to the Beginning of life, as opposed to the concept of personalistic bioethics which understands the beginning of a new life happens upon conception. Regarding the end of life, the concepts are divided, whereby half of researched authors admit palliative care as an exit for terminally-ill patients for them to be soothed in their suffering, just as the Ontologically Based Personalism also suggests, and the other half thinks the person needs independence to decide the end of his life, offering hence an opening to euthanasia. In regard to practicing health, the principle of independence appears predominantly as part of the base of medical practice, whereby this principle appears in some articles as the part of the person with the biggest importance in the patienthealthcare team relation. For personalistic bioethics, the ultimate criterion before the clinical practice has to serve as the foundation for the human person. Authors who work with public healthcare themes showed evident aspects related to vulnerable groups and to the need of State intervention, wherein the emphasis on the persons leadership has been missing, in addition to sociability and subsidiarity. Concerning eugenics, authors speak of tolerance toward it and respecting the will of the majority of society, while personalistic bioethics speak of considering what is different and diverse through the acknowledgment of human dignity. Thus, the concepts related to the definition of the human person are quite diverse in Brazil. In summary, it is necessary to help the Brazilian bioethical community become acquainted with the concept of the person as resumed by the Ontologically Based Personalism, by looking at our experience and by having our own reality as judgment criteria, as well as using this experience of person when it is necessary to take decisions in regard to life.

Ces travaux de thèse s’intéressent à une stratégie de fin de vie naissante : le repurposing. Nous le définissons comme un processus industriel par lequel des produits en fin d’usage sont réutilisés dans des applications distinctes. À la fin de leur premier usage, les produits sont réintégrés dans la chaine industrielle en vue d’une nouvelle utilisation dans une autre application. On parle également d’utilisations en cascade. Le but avoué est la conservation de la valeur-ajoutée des produits, aussi longtemps que possible. Cette stratégie s’inscrit aux côtés d’autres stratégies de réutilisation plus connues telles que le réemploi et le remanufacturing.L’illustration principale de la littérature, qui constitue également notre terrain d’étude, concerne les batteries au lithium. Utilisées initialement dans les véhicules électriques, elles sont aujourd’hui recyclées lorsque leurs capacités de stockage diminuent de 20 à 30%. Prolonger leur durée de vie par une seconde application, e.g. un usage stationnaire, permettrait de différer les étapes de recyclage tout en maximisant le maintien de la valeur ajoutée lors de la fabrication. Malgré ces avantages, les exemples de transformations de produits pour des applications en cascade restent à l’état de démonstrateurs, en particulier parce qu’aujourd’hui ces produits et leur chaine de valeur ne sont pas conçus avec des stratégies supportant leur réutilisation.L’objectif de ces travaux est d’apporter aux équipes de conception une vision claire de ce qu’est la stratégie de réutilisation en cascade, de comment l’intégrer lors des étapes amont du processus de conception et de guider l’évaluation environnementale correspondante, afin de les accompagner pour une réelle industrialisation des produits repurposés. En ce sens, nous émettons trois propositions.La première consiste en une classification des caractéristiques propres aux solutions en cascade selon trois axes : le produit, le processus de (re)fabrication et le modèle d’affaire envisagé. À travers ce cadre, nous décrivons les dimensions et les caractéristiques des offres de produits repurposés. Elles sont alors utilisables pour l’établissement de compromis dès les phases amont de conception. Celles-ci sont issues d’une étude bibliographique couplée à des études de terrain.Notre deuxième proposition concerne le processus de conception de tels produits. En effet, plusieurs spécificités sont à prendre en compte en comparaison d’une activité de conception classique : récupération du produit en fin d’usage, applications ultérieures pas ou peu définies, besoins flous, usage influençant les performances, etc. Une étape de conception pour les produits repurposés devra donc être intégrée en amont du processus de repurposing afin d’optimiser les solutions ultérieures. En complément, plusieurs recommandations pour la conception d’un produit repurposé sont formulées. Intégrées au plus tôt, elles visent à faciliter la réutilisation des produits en tenant compte des parties-prenantes, des phases du cycle de vie, des aspects temporels et en gérant mieux l’information.Enfin, un cadre générique structurant la réalisation d’analyses du cycle de vie de ces solutions est proposé. Les ACVistes pourront ainsi plus facilement tenir compte des spécificités de ces stratégies, car la complexité des modélisations ACV pour les produits aux applications en cascade nécessite davantage de rigueur et de précision que pour des produits à application unique. Pour supporter ce cadre, trois recommandations à destination des équipes de conception sont émises. Elles permettent la formalisation d'éléments de contexte pour améliorer la comparaison avec d’autres études et d’informations en vue des analyses de sensibilité.Ces trois propositions sont implémentées sur deux cas d’étude ‘batterie’, au cours de séances de travail regroupant des parties-prenantes de l’ensemble du cycle de vie : commanditaire, équipes de conception, logisticiens, recycleur, etc. / This PhD dissertation focuses on an innovative end-of-life strategy: repurposing. We define ‘repurposing’ as a manufacturing process through which products nearing their end-of-life are reused in different applications. At the end of their intended use, products are reintegrated into the manufacturing chain and adapted for their next application. We also refer to this strategy as cascading application reuse (CAR). The main purpose of CAR is the preservation of the added-value of such products. This strategy is in line with other reuse strategies such as direct reuse and remanufacturing.The central illustration in our case study addresses lithium-ion batteries used in electric vehicles, which are recycled when the battery’s charging capacity falls below 80%. Extending the component lifespan with a second application, e.g. stationary application, postpones introduction into the waste stream, retaining the added-value from the original manufacturing process. Despite these advantages, examples of product adaptation for CAR remain at a proof-of-concept scale - currently these products and their value chains are not yet designed with strategies supporting reuse.The objective of this research is to provide a clear vision to design teams about repurposing strategies, how to integrate the strategies during the upstream stages of the design process and how to facilitate the corresponding lifecycle assessment. The objective is to support designers during the manufacturing of repurposed products. We make three proposals.The first consists of classifying the characteristics specific to the repurposing strategy according to three axes: the product, the (re)manufacturing process and the business model. Through this framework, we describe the dimensions and characteristics of what the repurposed product offers, which are integral during the design activity. These attributes are the result of a study of the relevant literature coupled with several field investigations.Our second proposal concerns the design process for such products. Indeed, several differences with classical design practices appear: the need for product recovery at the end of use, subsequent applications and needs not fully defined, which affect performance, etc. A design stage for repurposed products must therefore be integrated before subsequent applications in order to optimise redesign solutions. Integrated as early as possible, they aim to facilitate product reuse by taking into account stakeholders, life cycle phases, time aspects and better information management.Finally, a generic framework structuring the carrying out of life cycle analyses of repurposing is proposed. This will simplify the inclusion of their specificities for life cycle assessments (LCA) practitioners. Indeed, the complexity of LCA modelling for cascading applications products requires more rigour and precision than single application products. To support this framework, three recommendations for design teams are made, the objective of which is to better formalise the information from the design process. These recommendations support the formalisation of contextual elements to improve comparison with other studies and the organisation of information for sensitivity analyses.These three proposals are implemented on two battery case studies, during working sessions involving stakeholders representing the complete life cycle: sponsor, design teams, logisticians, recycler, etc.

Bakgrund: Palliativ vård kännetecknas av att förbättra livskvaliteten i livets slutskede utifrån en helhetssyn. Det palliativa förhållningssättet omfattar alla patienter i livets slutskede, oavsett diagnos, och distriktssköterskan i hemsjukvården är både ett praktiskt och känslomässigt stöd. Ett personcentrerat förhållningssätt i samband med palliativ vård ger förbättrad livskvalitet och symtomlindring. Den personcentrerade modellen De 6 S:n främjar patientens syn på sig själv och sina önskemål i omvårdnaden. Syfte: Att beskriva distriktssköterskors erfarenheter av palliativ vård i livets slutskede inom hemsjukvården, utifrån ett personcentrerat perspektiv. Metod: Kvalitativ med deduktiv ansats. Två fokusgruppsintervjuer, 12 distriktssköterskor. Kvalitativ innehållsanalys utifrån De 6 S:n. Resultat: Självbild: Distriktssköterskan utgår från den enskilde patienten samt samordnar insatser för en välfungerande hemsituation. Självbestämmande främjas av hemmiljön och innebär visad respekt och lyhördhet. Sociala relationer bevaras genom anpassning och stödjande insatser. Symtomlindring omfattar främst farmakologiska insatser. Sammanhang omfattar samtal och främjas av hemmiljön, relationen till patienten och att distriktssköterskan ger tid och närvaro. Patientens strategier respekteras genom anpassning och stödjande insatser. Patientens önskemål möjliggörs med hjälp av närstående och omvårdnadspersonal.   Slutsats: Distriktssköterskorna utgår från och anpassar sig till patientens behov och resurser. Relationen, kommunikationen och hemmiljön främjar personcentrerat förhållningssätt. De 6 S:n utgör stöd för personcentrerad vård utifrån en helhetssyn. / Background: Palliative care is characterized by improving the quality of life in the final stages of life based on a holistic view. The palliative approach covers all patients in the final stages of life, regardless of diagnosis, and the district nurse in home health care gives both practical and emotional support. A person-centered approach in connection with palliative care provides improved quality of life and symptom relief. The person-centered model The 6 S:n promotes the patient's view of himself and his wishes in the nursing. Aim: To describe district nurses' experiences of palliative care in the final stage of life in home care, from a person-centered perspective. Method: Qualitative with deductive approach. Data collection through two focus group interviews, 12 district nurses. Qualitative content analysis based on The 6 S:n. Result: Self-image: The district nurse starts from the individual patient and coordinates efforts for a well-functioning home situation. Self-determination is promoted by the home environment and means shown respect and sensitivity. Social relations are preserved through adaptation and supportive efforts. Symptom relief mainly involves pharmacological interventions. Summary includes conversations which is promoted by the home environment, the relationship with the patient and that the district nurse gives time and attendance. The patient's strategies are respected through adaptation and supportive efforts. The patient's wishes are made possible with the help of relatives and assistant nurses. Conclusion: The district nurses focus on and adapt to the patient's needs and resources. The relationship, communication and the home environment promote person-centered approach. The 6 S:n provides support for person-centered care based on a holistic approach.

<p>Полазећи од анализе рециклаже ELV у Србији и свету, анализиран је аспект одрживости и дефинисан модел одрживе рециклаже ELV. Применом fuzzy вишекритеријумског приступа, статистичких метода, Delphy методе и симулационих метода утврђени су кључни фактори успеха одрживости рециклаже ELV. Применом fuzzy приступа и симулационих динамичких модела за област рециклаже ELV, утврђен је утицај фактора одрживости рециклаже ELV на: (1) ниво рециклаже, (2) процес рециклаже у Србији и (3) одрживи развој Србије.</p> / <p>Polazeći od analize reciklaže ELV u Srbiji i svetu, analiziran je aspekt održivosti i definisan model održive reciklaže ELV. Primenom fuzzy višekriterijumskog pristupa, statističkih metoda, Delphy metode i simulacionih metoda utvrđeni su ključni faktori uspeha održivosti reciklaže ELV. Primenom fuzzy pristupa i simulacionih dinamičkih modela za oblast reciklaže ELV, utvrđen je uticaj faktora održivosti reciklaže ELV na: (1) nivo reciklaže, (2) proces reciklaže u Srbiji i (3) održivi razvoj Srbije.</p> / <p>Starting from the analysis of the ELV recycling in Serbia and the world, the<br />aspect of sustainability and sustainable model defined ELV recycling is<br />analyzed. Application of fuzzy multi-criteria approach, statistical methods,<br />Delphy methods and simulation methods identified are key success factors in<br />the sustainability of ELV recycling. By application of fuzzy approach and<br />dynamic simulation models for the ELV recycling, influence of ELV recycling<br />sustainability factors is determined on: (1) the level of recycling, (2) the<br />recycling process in Serbia, and (3) the sustainable development of Serbia.</p>

Une évolution récente de la loi a rendu les directives opposables juridiquement et ainsi plus « contraignantes » pour les équipes médicales. Or dans la pratique des soins palliatifs, les soignants sont souvent confrontés à un refus des patients de se prononcer sur un choix anticipé concernant les décisions de fin de vie. À travers une étude qualitative par entretiens semi dirigés et une analyse textuelle du discours de 12 patients en situation palliative et 10 de leurs proches, nous avons étudié les freins et des leviers à la rédaction des directives anticipées chez ces patients. Au-delà du passage à l’écrit, c’est l’élaboration des DA elles-mêmes qui semble difficile chez ces patients. L’impossibilité d’imaginer, de conceptualiser le temps du mourir, bien que le pronostic soit connu, conduit à une incapacité à rédiger des DA. Un des enjeux de ces DA au-delà de leur rédaction, serait de les utiliser comme un médium de communication entre patients ou futurs patients et équipe médicale. Le partage d’une éventuelle décision concernant la fin de vie avec les proches ainsi qu’avec les équipes médicales, apparait comme indispensable. Ces échanges s’inscrivent dans un processus dynamique tenant compte de la temporalité du patient mais aussi des étapes évolutives de la pathologie, garantissant ainsi une meilleure adéquation entre situation vécue et DA. Les DA sous la forme de documents écrits ne sont pas conformes aux souhaits des patients et des proches que nous avons interrogés. La notion de discussions anticipées et d’« advance care planning » associant l’entourage, semble être plus approprié aux attentes des patients en situation palliative. Pour les proches, des discussions anticipées régulières en dehors de tout contexte médical pathologique paraissent un moyen adapté au recueil de leurs souhaits et valeurs. D’un acte individuel de rédaction, reflet de l’expression de l’autonomie de l’individu, nous devrions tendre vers une approche plus systémique. / An evolution of the law is undertaken in order to make advance directives judiciously enforceable and thus made more binding for the medical teams. However, in the practice of palliative cares, the nursing teams are often confronted to a refusal from the patients when they have to make an anticipated choice concerning the end of their life. Through a qualitative study by semi-directed interviews and a textual analysis of the speech of 12 patients in palliative situation and 10 of their relatives, we studied the brakes and levers in the drafting of advance directives in these patients. Beyond the transition to writing of directives, it is the elaboration of the ADs itself that is seemingly difficult for patients in a palliative situation. The impossibility of imagining or conceptualizing the time of death, although the prognosis is known, leads to an inability to write ADs. One of the challenges of these ADs, beyond their actual writing, would be to use them as a communication medium between patients or future patients and the medical team.The sharing of a possible end-of-life decision with relatives as well as with the medical teams, appears essential. These exchanges are part of a dynamic process taking into account the temporality of the patient but also the various evolutionary stages of the disease thus ensuring a better match between an experienced situation and ADs. ADs in the form of written documents do not conform to the wishes of the patients and relatives we interviewed.For relatives, regular early discussions outside of any pathological medical context seem to be a suitable way of collecting their wishes and values. The notion of anticipatory discussions and « advance care planning » associating the entourage, would appear to be more in line with the expectations of patients in a palliative situation. From an individual act of writing, reflecting the expression of autonomy of the individual, we should tend towards a more systemic approach.

Bakgrund: När en patient får en diagnos eller sjukdom kan vården vara inriktad på kurativ eller palliativ vård eller både och. Vård med kurativ inriktning syftar till att bota sjukdom medan palliativ vård syftar till att lindra den. Att vårda i transitionen kan vara komplext för sjuksköterskan vars uppgift är att stödja patienten genom hälsorelaterade transitioner. För att kunna göra det krävs en förtroendefull relation mellan patient och sjuksköterska samt tydliga riktlinjer för sjuksköterskan att förhålla sig till. Syfte: Syftet var att beskriva sjuksköterskors upplevelse av att vårda patienter i övergången från kurativ till palliativ vård. Metod: Metoden som använts är en litteraturöversikt som syftar till att skapa en överblick över det valda kunskapsområdet. Resultatet har författarna baserat på elva vetenskapliga artiklar varav 10 var kvalitativa och en var kvantitativ. Artiklarna söktes fram i databaserna Cinahl Complete, Pubmed och Medline. Resultat: Resultatet presenteras utifrån tre huvudteman med tillkommande subteman. Huvudteman; Sjuksköterskan i transitionen, Sjuksköterskans förutsättningar att vårda i transitionen och Vårdmiljöns betydelse i transitionen. Diskussion: Utifrån Meleis transitionsteori diskuterade författarna resultatet som var relaterat till sjuksköterskors upplevelser av att vårda patienter i övergången från kurativ till palliativ vård på vårdavdelningar. Konsensusbegreppet miljö diskuteras även av författarna i resultatdiskussionen utifrån inre och yttre miljöomständigheter. / Background: When a patient's gets a diagnosis or a disease healthcare can be orientedon palliative or curative care. Curative aims to to cure disease, whilstpalliative care aims to alleviate. To care in the transition can be complexfor the nurse who’s aim is to support the patient through health relatedtransitions. That requires a trustful relationship between the patient andthe nurse and that the nurse has clear guidelines during the transition torelate to. To do so requires a relationship of trust between the patient andthe nurse, as well as clear guidelines for the nurse to relate to during thetransition. Aim: The aim was to highlight nurses´ experiences trough the transition fromcurative to palliative care. Method: The method was a literature review that aims to create an overview of thechosen field of knowledge. The authors created the result based on elevenscientific articles, ten were qualitative and one of them were qualitative.The articles were sought out in the databases Cinahl Complete, Pubmedand Medline. Results: The results were presented in three main themes with four additionalsubthemes. The main themes; The nurse in the transition, The nurseability to care in the transition and The meaning of the caringenvironment in the transition. Discussion: The authors have discussed the result from Meleis transitions theorywhich is related to nurse’s experiences from caring for patients in thetransition from curative to palliative care. The consensus definition ofenvironment is discussed in the result from internal and external carecircumstances.

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Parlare di morte è un tabù della nostra società. L'incremento quantitativo di pazienti terminali impone peraltro uno sforzo per il miglioramento della loro qualità di vita. Lo psicologo deve comprendere la domanda sociale su questi temi, per costruire un adeguato intervento clinico-formativo rivolto agli operatori sanitari. Obiettivi della ricerca sono di individuare: la rappresentazione di disponibilità di Cure Palliative (CP); gli atteggiamenti degli operatori sanitari e del pubblico circa le diverse opzioni di fine vita (End-Of-Life, EOL), verificando l'ipotesi che i sanitari e in particolare i palliativisti siano meno favorevoli all'eutanasia e più alle CP; i predittori delle opinioni; l'influenza delle difficoltà concettuali sulla stabilità delle opinioni; il rapporto tra le opinioni e la rappresentazione delle CP; le diverse percezioni dei bisogni del paziente terminale; il burnout dei palliativisti rispetto agli altri sanitari. 524 soggetti (265 sanitari, di cui 118 palliativisti; 259 non-sanitari) hanno compilato un questionario self-report, sviluppato ad-hoc. Ai 265 sanitari è stato inoltre somministrato il Maslach Burnout Inventory. I non-sanitari risultano più favorevoli all'eutanasia e meno alle CP rispetto ai sanitari. Analisi lineari indicano, fra i predittori dell'accordo all'eutanasia, religiosità e lavoro sanitario; le opinioni risultano peraltro instabili. Il campione presenta livelli di burnout significativamente inferiori alla media italiana; i palliativisti segnalano un burnout minore dei colleghi nella dimensione EE; il sostegno alla relazione costituisce elemento protettivo. L'incidenza di fattori non misurabili indica l'opportunità di approfondimenti qualitativo-idiografici. Lo studio suggerisce la necessità di una maggiore conoscenza delle tematiche EOL. Lo psicologo deve sostenere presso i caregiver un luogo simbolico per l'elaborazione dell'evento-morte. / In our society death is a taboo topic. The increase of dying patients calls for an improvement in their quality of life. Psychologists need to understand the social demand on these issues, in order to promote appropriate clinical and training interventions for health workers. In this research we looked at the representation of availability of Palliative Care (PC) as well as attitudes of health workers and the general public towards different End-Of-Life (EOL) options. We tested the hypothesis that health workers and especially palliative care workers disagree with euthanasia and agree with PC more than the public. We also investigated attitudes predictors; the influence of conceptual difficulties on attitudes stability; the relationship between attitudes on euthanasia and PC representation; different perceptions of dying patients' needs; palliative care and other health workers' burnout. 524 subjects (265 health workers: 118 involved in palliative cares and 147 in other health sectors; 259 from the general public) filled in a self-report questionnaire, created ad-hoc. The 265 health workers also filled in the Maslach Burnout Inventory. The public, compared to health workers, agreed more with euthanasia and less with PC. Linear analysis indicates that religious beliefs and health work are the only significant predictors of this agreement, even if attitudes are quite unstable. The burnout levels in our sample are significantly lower than Italian mean levels. Palliative care workers show lower levels in EE subscale than their colleagues; supporting relationships are a protective factor. The incidence of non-measurable factors suggests the opportunity of further qualitative studies. This research highlights the need for deeper knowledge of EOL issues. Psychologists should give to all professional carers the opportunity for reflective practice and symbolic work on the event of dying.

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