Therapiereduktion in der Intensivmedizin : "Sterben zulassen" durch bewusste Begrenzung medizinischer Möglichkeiten.
Traduction en anglais : Limitation of therapy in final stages of critical illness.
The conversion of an, attempt to treat « to, prolongation of dying » represents an important problem in modern intensive care.
If the actual or presumed will of the patient is unknown, the physician has to decide about the extent of treatment in a paternalistic manner.
In these difficult decisions the physician has to consider prognosis, and certainty of prognosis and has to carefully balance between the right to live and the right to die.
This decision about the extent of therapy is a very personal medical activity and can be taken off the physician's shoulders by nobody.
Consultation with other physicians involved, relatives, nurses and clergy, however, is mandatory, as a joint decision should be sought.
If the situation is hopeless and further medical interventions are futile, then allowing the patient to die by therapy reductions is not only a possibility but a mandatory act of humanity.
In that case it does not matter whether new treatment modalities are abandoned or whether already instituted medical measures are withdrawn.
In clinical practice, however, the, fine tuning of therapy reduction has to be tailored to the individual case and largely depends on prognostic certainty.
Mots-clés Pascal : Soin intensif, Stade terminal, Traitement, Ethique, Attitude, Homme, Prise décision, Pronostic, Allemagne, Médecin, Europe
Mots-clés Pascal anglais : Intensive care, Terminal stage, Treatment, Ethics, Attitude, Human, Decision making, Prognosis, Germany, Physician, Europe
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 96-0118861
Code Inist : 002B30A09. Création : 199608.