Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jan 2015
[Nocebo effects with the informed consent].
Side effects are more frequent and severe, or simply appear by just talking about them. But not the informed consent is to be challenged, rather the form of giving risk information. Nocebo effects mainly originate from induced negative expectations, not from the information itself. Concerns about legal consequences of an incomplete list of risks do not release from the responsibility to guide and help the patient to an understanding and a balanced decision.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jan 2015
[Ethical challenge in palliative support of intensive care patients].
Intensive care medicine and palliative care medicine were considered for a long time to be contrasting concepts in therapy. While intensive care medicine is directed towards prolonging life and tries to stabilize disordered body functions, palliative care medicine is focused upon the relief of disturbances to help patients in the face of death. Today both views have become congruent. ⋯ In the course of illness or in respect of the patient's will, the aim of therapy may change from curative to palliative. Two examples are presented to illustrate the ethical challenges in this process. They follow from the medical indication, attention to the patient's will, different opinions in the team, truth at the bedside and from what must be done in the process of withdrawing therapy.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jan 2015
[Conversations about end-of-life in the intensive care unit].
End-of-life decisions are frequently necessary in intensive care units. These decisions are made more difficult through rapidly changing disease dynamics, lack of continuity of care, differing expectations, as well as a lack of support. In these situations, structured communication concepts can help families and staff, e. g. through structured family conferences, the concept of family as the expert for the patient's preferences, and empathetic reactions to emotions. The article discusses concrete strategies how to communicate about end-of-life care.