Wiese, C. H. R. and Duttge, G. and Weber, A. K. and Zausig, Y. A. and Ruppert, D. and Hanekop, G. G. and Graf, B. M. (2009) Emergency medical treatment of palliative care patients at the end of life Regulatory emergency medical care framework - a case control investigation of medical intervention and advance directives. ANAESTHESIST, 58 (11). pp. 1097-1106. ISSN 0003-2417,
Full text not available from this repository. (Request a copy)Abstract
The treatment of out-of-hospital palliative emergency care situations during cardiac arrest is a special situation. The prehospital emergency physician (EP) and the paramedic must be informed about the medical, legal, and ethical specifics of these situations, but this knowledge is not integrated within emergency medical curricula at all. We present a case study to discuss such legal and ethical specifics. We retrospectively analysed six emergency cases with palliative care patients in the final stages of their illnesses. On the basis of these case studies, we present six different emergency cases with different regulatory frameworks for each EP and paramedic. In accordance with the Declaration of Helsinki, data were collected pseudonymously. The six case studies show therapeutic concepts concerning the emergency medical care of palliative care patients during cardiac arrest. The differences are apparent in the treatment given by EPs and by paramedics (such as whether to start or stop resuscitation). EPs and paramedics differ in their therapeutic approach to these specific situations (e.g. paramedics more often start resuscitation during cardiac arrest even though patients would refuse this according to their advance directives). These differences may be important for the patient and his or her caregivers. Every EP and paramedic may be involved in the care of palliative care patients who are at the end of their lives. EPs and paramedics do not always adapt their treatment to the will or supposed will of the patient (especially in accordance with the new German law concerning advance directives). The reasons for this usually concern legal uncertainties. Therefore, EPs and paramedics should know that different legal meanings could be important in emergency medical care therapy of palliative care patients. A written "do not resuscitate" order as an advance directive must be evaluated as a desired therapeutic limitation.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | ANALGESIC-BASED SEDATION; ETHICAL CONFLICTS; ONCOLOGY PATIENTS; PHYSICIANS; LEGITIMACY; SERVICES; DISEASE; BORDER; Emergency medicine; Palliative medicine; Emergency medical algorithms; Advance directive; End-of-life decisions |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Anästhesiologie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 02 Sep 2020 06:41 |
| Last Modified: | 02 Sep 2020 06:41 |
| URI: | https://pred.uni-regensburg.de/id/eprint/28162 |
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