Janssens U, Burchardi H, Duttge G, Erchinger R, Gretenkort P, Mohr M, Nauck F, Rothärmel S, Salomon F, Schmucker P, Simon A, Stopfkuchen H, Valentin A, Weiler N, Neitzke G
Klinik für Innere Medizin, St. Antonius Hospital Eschweiler, Dechant-Deckers-Str. 8, 52249 Eschweiler, Deutschland.
Anaesthesist. 2013 Jan;62(1):47-52. doi: 10.1007/s00101-012-2126-x.
The task of physicians is to maintain life, to protect and re-establish health as well as to alleviate suffering and to accompany the dying until death, under consideration of the self-determination rights of patients. Increasingly more and differentiated options for this are becoming available in intensive care medicine. Within the framework of professional responsibility physicians must decide which of the available treatment options are indicated. This process of decision-making is determined by answering the following question: when and under which circumstances is induction or continuation of intensive care treatment justified? In addition to the indications, the advance directive of the patient is the deciding factor. Medical indications represent a scientifically based estimation that a therapeutic measure is suitable in order to achieve a defined therapy target with a given probability. The ascertainment of the patient directive is achieved in a graded process depending on the state of consciousness of the patient. The present article offers orientation assistance to physicians for these decisions which are an individual responsibility.
医生的任务是维持生命、保护和恢复健康、减轻痛苦以及陪伴临终者直至死亡，同时要考虑患者的自我决定权。在重症医学领域，越来越多且多样化的手段可供选择。在职业责任框架内，医生必须决定哪些可用的治疗方案是合适的。这个决策过程取决于对以下问题的回答：何时以及在何种情况下进行重症监护治疗的诱导或延续是合理的？除了适应症外，患者的预先指示也是决定性因素。医学适应症是基于科学的评估，即一种治疗措施适合以给定的概率实现特定的治疗目标。根据患者的意识状态，通过一个分级过程来确定患者的指示。本文为医生在这些属于个人责任的决策中提供指导帮助。
