Medizinische Klinik, Intensivmedizin und Notfallmedizin
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Therapy decisions in the care of critically ill and dying patients in intensive care and emergency medicine must reflect probably conflicting issues of medical indications, ethics and law. This is of particular relevance when treatment preferences of patients are not known or are in contrast to those of the carers. Difficulties regarding prognostication or with determining the beginning of an irreversible dying process may also lead to treatment situations that need ethical reflection. It is recommended to tackle medico-ethical issues by discussion of the meaning of relevant terms and medico-ethical principles, analyzing the professional self-image in intensive care and emergency medicine, consideration of options of palliative medicine and by use of an ethics case consultation.
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Med Klin Intensivmed Notfmed · Sep 2011
Review[Geriatric patients in intensive care medicine. Ethical aspects].
Due to demographic change and progress in medicine, the percentage of geriatric patients treated in intensive care is continuously increasing. In addition to the acute disease, many of these patients may also have chronic illnesses, multimorbidity, and cognitive limitations. ⋯ The denial of access to intensive care, however, cannot be justified by the advanced age of the patient alone. This would display an ethically problematic form of discrimination (ageism).
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Med Klin Intensivmed Notfmed · Sep 2011
Review[Medical geriatric aspects in intensive care therapy of elderly patients].
For elderly patients specific medical problems, such as the consequences of aging organs, comorbidities or geriatric syndromes must be considered in the intensive care treatment of acute diseases. Under these circumstances special instruments for geriatric assessment are particularly useful. Up to now geriatrics and intensive care medicine have made complementary contributions in the treatment of severely ill elderly patients. A closer interdisciplinary cooperation of the two disciplines could be of substantial beneficial value in the care of the sick and elderly to overcome the many open questions and pressing problems.