Zusammenfassung
Die Ermittlung des Patientenwillens ist in der Notfall- und Intensivmedizin oft schwierig.
Die Beachtung des Willens stellt ein juristisches und ethisches Gebot dar, der Patient
ist jedoch häufig nicht selbst einwilligungsfähig. Dieser Beitrag beschreibt den Prozess
der Ermittlung des Patientenwillens und zeigt, welche Bedeutung eine Patientenverfügung,
andere Behandlungswünsche oder der mutmaßliche Wille für die Behandlungsentscheidung
haben.
Abstract
It is legally required to determine and respect patient preferences and wishes as
much as possible under the circumstances given. This also applies to emergency medicine
and intensive care, particularly if a patient is unconscious and is not able to give
his consent by him-/herself. According to German law, patientsʼ explicit written statements
(advance directive, living will) are mandatory. If no advance directive is available,
or if the directive does not match the current medical circumstances, other (oral)
statements of the individual patient have to be scrutinized to identify presumed wishes
and establish presumed consent. Such wishes are equally binding. The article explicates
the role of legal proxies (legal guardians, patient representatives) in determining
patientsʼ wishes. Detailed instructions and recommendations are given to medical staff
on how to support legal representatives and next of kin with respect to shared decision-making
and the process of determining patient preferences. This way, patient autonomy and
patientsʼ rights can be protected best.
Schlüsselwörter
Patientenwille - Patientenverfügung - Behandlungswunsch - mutmaßlicher Patientenwille
- Einwilligungsfähigkeit
Key words
patient preferences - living will - advance directives - presumed wishes - capacity
to consent
