Wiesinger Karlheinz, Christof Müller-Busch H
Mobiles Hospiz Rennweg, Betreuung zu Hause Ges.m.b.H., Wien, Austria.
Wien Med Wochenschr. 2010 Jul;160(13-14):343-8. doi: 10.1007/s10354-010-0820-3.
Informed consent is the condition for treating a patient, in curative and palliative settings. If, due to the medical situation, a valid consent cannot be acquired a substituted judgement based on information about the patients preferences will be applied. Accordingly the mobile palliative team of Caritas Socialis requires that patients are informed about their disease condition and agree to palliative measures. The team asks for clear communication about end of life situations, death and dying, which is sometimes difficult for relatives and patients. Sometimes defense mechanisms appear to deny the true situation in order to cope with the disease. The case report shows an example of a particular problematic challenge to combine palliative ideas with impossible curative hopes. An open discussion tries to clarify positions and seeks for future solutions.
在治疗性和姑息性医疗环境中,知情同意是治疗患者的前提条件。如果由于患者的病情无法获得有效的同意,则将根据有关患者偏好的信息应用替代判断。因此,明爱社会福利机构的流动姑息治疗团队要求告知患者其病情,并同意采取姑息治疗措施。该团队要求就生命终结情况、死亡和临终问题进行清晰的沟通,这对亲属和患者来说有时很困难。有时,防御机制似乎会否认真实情况以应对疾病。该病例报告展示了一个将姑息治疗理念与不切实际的治愈希望相结合的特殊难题的例子。一场公开讨论试图阐明各方立场并寻求未来的解决方案。