Dtsch med Wochenschr 2018; 143(01): 27-34
DOI: 10.1055/s-0042-109255
Dossier
© Georg Thieme Verlag KG Stuttgart · New York

Ethikberatung auf der Intensivstation: die „Klinisch Orientierte Beratungsmethode“

Ethics Consultation on the ICU: The Clinically Oriented Method of Counselling
Gerald Neitzke
Further Information

Publication History

Publication Date:
23 October 2017 (eFirst)

Abstract

When ethical conflicts arise on the ICU, an ethics case consultation is useful. The aim of this consult is a qualified reflection of the moral values, convictions and assumptions involved in the case. The “clinically oriented method of counselling” provides an adequate structure for case consultations on the ICU. The moral assumptions and estimations contained in medical indications, prognosis, therapeutic aims, risk-benefit assessment and issues of quality of life are discussed and a consensus is sought for. This method is familiar to hospital staff and will effectively support mutual understanding and agreement among physicians, nursing staff and family members. A consensus, facilitated by ethics consultation, expresses the shared belief, that the therapeutic options in question are both scientifically sound and humane. On the one hand the consensus assures the appropriateness of therapeutic goals and therapeutic means, on the other hand it proves the assessment, that patient wishes and preferences have been considered as conclusive as possible.

Ethische Konflikte auf der Intensivstation sind häufig. Insbesondere Fragen am Lebensende stellen das multiprofessionelle Team, Patienten und Angehörige vor moralische Herausforderungen. Je nach Perspektive kann eine Behandlung als sinnvolle Lebensverlängerung oder als quälende Sterbeverhinderung bewertet werden. Dieser Beitrag beschreibt, wie Ethikberatung das Behandlungsteam und die Angehörigen bei der Entscheidungsfindung unterstützen kann.