Die medizinische Indikation – ein “Kernstück ärztlicher Legitimation”?

Lipp, Volker

doi:10.1007/s00350-015-4126-8

Cited by 15 publications

(4 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…If a treatment is not or no longer indicated from a medical point of view, it is not permissible under German law and must be discontinued. However, a large number of publications in Germany show different definitions of the term medical indication, leading to ethical uncertainties in practice [ 31 – 33 ]. Only treatments that are actually indicated may be offered to the patient for consent.…”

Section: Methodsmentioning

confidence: 99%

Clinical ethics case consultation in a university department of cardiology and intensive care: a descriptive evaluation of consultation protocols

et al. 2021

View full text Add to dashboard Cite

Background Clinical ethics case consultations (CECCs) provide a structured approach in situations of ethical uncertainty or conflicts. There have been increasing calls in recent years to assess the quality of CECCs by means of empirical research. This study provides detailed data of a descriptive quantitative and qualitative evaluation of a CECC service in a department of cardiology and intensive care at a German university hospital. Methods Semi-structured document analysis of CECCs was conducted in the period of November 1, 2018, to May 31, 2020. All documents were analysed by two researchers independently. Results Twenty-four CECCs were requested within the study period, of which most (n = 22; 92%) had been initiated by physicians of the department. The patients were an average of 79 years old (R: 43–96), and 14 (58%) patients were female. The median length of stay prior to request was 12.5 days (R: 1–65 days). The most frequent diagnoses (several diagnoses possible) were cardiology-related (n = 29), followed by sepsis (n = 11) and cancer (n = 6). Twenty patients lacked decisional capacity. The main reason for a CECC request was uncertainty about the balancing of potential benefit and harm related to the medically indicated treatment (n = 18). Further reasons included differing views regarding the best individual treatment option between health professionals and patients (n = 3) or between different team members (n = 3). Consensus between participants could be reached in 18 (75%) consultations. The implementation of a disease specific treatment intervention was recommended in five cases. Palliative care and limitation of further disease specific interventions was recommended in 12 cases. Conclusions To the best of our knowledge, this is the first in-depth evaluation of a CECC service set up for an academic department of cardiology and intensive medical care. Patient characteristics and the issues deliberated during CECC provide a starting point for the development and testing of more tailored clinical ethics support services and research on CECC outcomes.

show abstract

Section: Methodsmentioning

confidence: 99%

Clinical ethics case consultation in a university department of cardiology and intensive care: a descriptive evaluation of consultation protocols

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Zudem werden sich umgekehrt die zur Verfügung stehenden Therapieoptionen daran bemessen lassen müssen, ob sie in der Lage sind, die erklärten Therapieziele in angemessener Weise zu erreichen (vgl. [27]). In einer im onkologischen Sinne "palliativen", d. h. inkurablen Erkrankungssituation stellt "Heilung" definitionsgemäß kein realistisches Therapieziel dar (zur Problematik des Begriffskonzepts von "Heilung" und "Heilbarkeit" s. einleitenden Abschn.…”

Section: Festsetzung Von Therapiezielenunclassified

“…Die medizinische Indikation stellt die fachlich begründete Einschätzung des behandelnden Arztes dar, dass eine konkrete Therapiemaßnahme angezeigt ist, um ein bestimmtes Therapieziel mit einer gewissen Wahrscheinlichkeit zu erreichen [43]. Die Indikation bestimmt so das Therapieangebot und begrenzt zugleich den ärztlichen Heilauftrag: Ist eine Therapiemaßnahme nicht indiziert, muss sie der Arzt nicht anbieten und kann ihre Durchführung verweigern; ist sie sogar kontraindiziert, darf er sie nicht einmal auf ausdrücklichen Wunsch des Patienten durchführen [27,36].…”

Section: Entscheidung üBer Beginn Fortsetzung Oder Beendigung Mediziunclassified