Ethik in der Medizin 10 (3):152-180 (1998)

Abstract
Definition of the problem: The report supplies the national part of a European survey in which doctors that are involved in the treatment of patients in `Persistent Vegetative State' (PVS) are being interviewed. The questions concern decision-situations the doctors are frequently confronted with in the treatment of PVS-patients. The questionnaire is designed as a decisiontree in order to bring about the exact delineations that govern the decisions. Therefore the result of the survey only portrays which delineations are in fact being accepted (and does not allow any conclusion concerning which norms should guide the decisions). Whether these factual delineations correspond to ethical-normative criteria that derive from guiding principles – such as human dignity – is being discussed in the part reflecting on the survey. It is crucial to an adequate interpretation of the survey results to keep in mind that the doctors were not being asked about what they actually did in the situations described; the survey was designed to bring about what the doctors' basic attitudes towards the problems are.Arguments: The reason this methodological approach to the problem was chosen is that an ethical evaluation can only take place when the action-guiding convictions of the agents concerned are known. The goal of the survey was to make a provisional orientation concerning the basic attitudes possible. Compared to other countries taking part in, the survey result in Germany confirms the hypotheses that doctors from different European countries – concerning the decisions of withdrawing treatment or withholding treatment – are guided by different basic attitudes.Conclusion: As it has become apparent that important national differences concerning the action-guided attitudes of the doctors exist, it would not be advisable to recommend that European guidelines for all countries should be set up for such cases. The decisions taken depend on the guiding ethical assumptions; they can only be decisions for the very case they were derived at.
Keywords Key words: Autonomy of the patient  Decision making  Persistent vegetative state (PVS)  Quality of life  Withdrawing/withholding treatment  Living will  Schlüsselwörter: Patientenautonomie  Entscheidungsfindung  persistierendes apallisches Syndrom  Lebensqualität  Behandlungsabbruch/-verzicht  Patientenverfügung
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DOI 10.1007/s004810050029
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„Wachkoma“ und Ethik.Dr med Gisela Bockenheimer-Lucius - 2005 - Ethik in der Medizin 17 (2):85-89.
„Wachkoma“ und Ethik.Gisela Bockenheimer-Lucius - 2005 - Ethik in der Medizin 17 (2):85-89.

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