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[Selected legal aspects regarding limiting treatment at the end of life : Patient advance directive, proxy and indications].

作者信息

Duttge Gunnar, Chabiera Peter Jan

机构信息

Zentrum für Medizinrecht, Universität Göttingen, Platz der Göttinger Sieben 6, 37073, Göttingen, Deutschland.

Institut für Kriminalwissenschaften, Georg-August-Universität, Platz der Göttinger Sieben 6, 37073, Göttingen, Deutschland.

出版信息

Med Klin Intensivmed Notfmed. 2023 Oct;118(7):598-608. doi: 10.1007/s00063-023-01065-0. Epub 2023 Sep 27.

DOI:10.1007/s00063-023-01065-0
PMID:37755458
Abstract

Respect for the patient's right to self-determination and the professional medical assessment of the (continued) existence of a therapeutic prospect of success of the respective curative intervention ("indication") are the two central reference parameters of every medical therapeutic decision. This is particularly true in cases of a progressive, irreversible, fatal course of the disease. However, the assessment of the presumed will of the patient or the meaningfulness of curative (intensive care) prolongation of life frequently causes difficulties. The law cannot eliminate these doubts in each individual case; it does, however, provide a framework so that factually and ethically justified therapy decisions can be made in each case. In this function, this legal framework-no matter how much it must first be concretized in the respective decision case-demands strict observance. This also includes the most recent change in the law that went into effect on 1 January 2023, through the introduction of a statutory right of (emergency) representation for spouses.

摘要

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本文引用的文献

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[The law of emergency representation in intensive care medicine].[重症医学中的紧急代理法]
Dtsch Med Wochenschr. 2022 Nov;147(22):1464-1469. doi: 10.1055/a-1665-1191. Epub 2022 Nov 1.
2
[Overtreatment in intensive care medicine-recognition, designation, and avoidance : Position paper of the Ethics Section of the DIVI and the Ethics section of the DGIIN].[重症医学中的过度治疗——识别、界定与避免:德国重症与急救医学协会伦理委员会及德国重症监护与感染病学会伦理委员会立场文件]
Med Klin Intensivmed Notfmed. 2021 May;116(4):281-294. doi: 10.1007/s00063-021-00794-4. Epub 2021 Mar 1.
3
[Legal implications of overtreatment].
[Palliative extubation after ROSC in the emergency setting-a guideline for emergency physicians].[急诊环境下心肺复苏后自主循环恢复后的姑息性拔管——急诊医师指南]
Med Klin Intensivmed Notfmed. 2025 Apr 29. doi: 10.1007/s00063-025-01271-y.
[过度治疗的法律影响]
Med Klin Intensivmed Notfmed. 2019 Apr;114(3):229-233. doi: 10.1007/s00063-019-0545-z. Epub 2019 Feb 11.
4
[Limits of the meaningfulness of intensive care medicine : Position paper of the Ethics Section of DIVI].[重症监护医学意义的局限性:德国重症与急诊医学协会伦理委员会立场文件]
Med Klin Intensivmed Notfmed. 2016 Sep;111(6):486-92. doi: 10.1007/s00063-016-0202-8.