title: The issue of legal protection of the intensive care unit physician within the context of patient consent to treatment. Part I: conscious patient, refusing treatment.
abstract: In daily clinical practice, physicians working in intensive care units (ICUs) face situations when their professional duty to protect the patient's life is in conflict with the obligation to respect the will of the patient and to assess his or her chances of treatment. Although the mere fact of conflict between these fundamental values for the ICU physician is a natural and obvious element in the chosen specialisation, many 'non-medical' circumstances make the given conflict not only very difficult but also dangerous for the physician. So far, the ethical and legal aspects of dying have been commented upon by a large group of lawyers and experts involved in the interpretation of the Polish regulations. The authors believe that a detailed analysis of the regulations should be carried out by persons of legal education, possessing a genuine medical experience associated with the specificity of end of life care in ICUs. In this paper, the authors have compared the current regulations of legislative acts of the common law relating to medical activities at anaesthesiology and intensive care units as well as based on the judgements of the common court of law over the past ten years. In the act of dissuading an ICU doctor from a medical procedure, all factors influencing the doctor's responsibility should be taken into account in accordance with the criminal law. In the case of a patient's death due to a refusal of treatment with the patient's full awareness, and given proper notification as to the consequences of refusing treatment, the doctor's responsibility lies under article 150 of the Polish penal code.
authors.affiliation: Department of Medical Law, Chair of Forensic Medicine, Piastowie Śląscy Medical University in Wrocław, Poland Department of Anaesthesiology and Intensive Therapy, Health Care Centre in Bolesławiec, Poland. jacek.siewiera@gmail.com.
authors.forename: Jacek
authors.initials: J
authors.lastname: Siewiera
authors.forename: Jakub
authors.initials: J
authors.lastname: Trnka
authors.forename: Andrzej
authors.initials: A
authors.lastname: Kübler
mesh_terms: D000328:Adult; D000368:Aged; D000776:Anesthesiology / Q000331:legislation & jurisprudence*; D003243:Consciousness; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D010817:Physician-Patient Relations; D010820:Physicians / Q000331:legislation & jurisprudence*; D011044:Poland; D016312:Treatment Refusal