Therapiezieländerungen auf der Intensivstation – Definitionen, Entscheidungsfindung und Dokumentation

Zusammenfassung

Multidisziplinäre Arbeitsgruppe (ARGE) Ethik in Anästhesie und Intensivmedizin der Österreichischen Gesellschaft für Anästhesiologie, Reanimation, Intensivmedizin (ÖGARI)

Die vorliegende Arbeit soll Ärzten Hilfestellung bei Entscheidungen in intensivmedizinischen Grenzbereichen geben. Anhand einer strukturierten Checkliste werden die zwei Säulen jeder medizinischen Entscheidung, die Indikation und der Patientenwille in systematischer Weise abgefragt. Vier Stufen möglicher Therapiezieländerungen werden erläutert und Empfehlungen für die korrekte Dokumentation von Therapiezieländerungen vorgestellt.

The present work provides assistance for physicians concerning decision making in clinical borderline situations in the ICU. Based on a structured checklist the two fundamental aspects of any medical decision, the medical indication and the patient's preference are queried in a systematic way. Four possible steps of withholding and/or withdrawing therapy are discussed. Finally, recommendations regarding appropriate documentation of end of life decisions are provided.

Schlüsselwörter:

Intensivmedizin - Ethik - Therapiezieländerung - Patientenwille - Indikation - Dokumentation

Key words:

End-of-Life decisions - Ethics - patient preference - medical indication - documentation

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