Department of Anaesthesiology, General Intensive Care and Pain Management Medical University of Vienna, Austria.
BMC Med Ethics. 2010 Oct 21;11:19. doi: 10.1186/1472-6939-11-19.
Currently, intensive care medicine strives to define a generally accepted way of dealing with end-of-life decisions, therapy limitation and therapy discontinuation.In 2006 a new advance directive legislation was enacted in Austria. Patients may now document their personal views regarding extension of treatment. The aim of this survey was to explore Austrian intensive care physicians' experiences with and their acceptance of the new advance directive legislation two years after enactment (2008).
Under the aegis of the OEGARI (Austrian Society of Anaesthesiology, Resuscitation and Intensive Care) an anonymised questionnaire was sent to the medical directors of all intensive care units in Austria. The questions focused on the physicians' experiences regarding advance directives and their level of knowledge about the underlying legislation.
There were 241 questionnaires sent and 139 were turned, which was a response rate of 58%. About one third of the responders reported having had no experience with advance directives and only 9 directors of intensive care units had dealt with more than 10 advance directives in the previous two years. Life-supporting measures, resuscitation, and mechanical ventilation were the predominantly refused therapies, wishes were mainly expressed concerning pain therapy.
A response rate of almost 60% proves the great interest of intensive care professionals in making patient-oriented end-of-life decisions. However, as long as patients do not make use of their right of co-determination, the enactment of the new law can be considered only a first important step forward.
目前，重症监护医学致力于定义一种普遍接受的处理临终决策、治疗限制和治疗终止的方法。2006 年，奥地利颁布了一项新的预先指示立法。现在，患者可以记录他们对治疗延长的个人意见。本调查的目的是在新的预先指示立法颁布两年后（2008 年），探讨奥地利重症监护医师的经验和对该立法的接受程度。
在 OEGARI（奥地利麻醉学、复苏和重症监护学会）的支持下，向奥地利所有重症监护病房的医疗主任发送了一份匿名问卷。问题集中在医生对预先指示的经验及其对相关立法的了解程度上。
共发出 241 份问卷，收回 139 份，回复率为 58%。约三分之一的回答者表示没有预先指示的经验，只有 9 名重症监护病房主任在过去两年中处理了超过 10 份预先指示。支持生命的治疗措施、复苏和机械通气是主要拒绝的治疗方法，主要表达的是对疼痛治疗的意愿。
近 60%的回复率证明了重症监护专业人员对制定以患者为导向的临终决策的极大兴趣。然而，只要患者不利用他们的共同决定权利，新法律的颁布只能被视为向前迈出的重要第一步。
