[Typical medical problems at the end of life: experiences in the intensive care unit].
Current regulations regarding living wills need to be revised in order to avoid conflicts between patients or their relatives/surrogates on one side, and physicians on the other. For wording the will the patient should seek not only legal, but also medical advice. For doctors treating the patient, it would be helpful if a written statement existed in which the patient identifies what kind of medical treatment he/she wants. This would apply to cases in which a patient's illness or injury precludes decision-making. Such a will could be stored on a still-to-be-established "health check card." By way of this card, the physician treating the patient could retrieve information about any living will in addition to the purely medical information. Despite potential gaps and uncertainties a patient's living will indicates to the physician that this patient has certain expectations regarding his/her treatment. In the event of a patient falling unconscious, the physician must talk to the relatives/surrogates in order to explore the patient's expectations about his/her treatment as nearly as closely as possible. This is the only way for the medical practitioner to meet his/her obligation towards the patient.
Schaffartzik
Walter
W
Klinik für Anästhesiologie, Intensivmedizin und Schmerztherapie, Unfallkrankenhaus Berlin. Walter.Schaffartzik@ukb.de
D003220:Conflict, Psychological; D003422:Critical Care / Q000592:standards*; D003657:Decision Making; D005190:Family; D006801:Humans; D007362:Intensive Care Units / Q000592:standards*; D007398:Interpersonal Relations; D010817:Physician-Patient Relations; D013727:Terminal Care / Q000592:standards*; D014789:Visitors to Patients