Therapiezielermittlung, Vorsorgeplanung und Gesprächsführung in der Notaufnahme
摘要
Patients with life-limiting illnesses represent a relevant proportion of individuals presenting to emergency departments. A relevant number of these patients die during hospitalization, which is often not the preferred place of death. Determining the (presumed) will of patients in emergency settings can be difficult. The resulting overtreatment and/or undertreatment can cause substantial distress for all parties involved. Written advance directives, such as living wills, emergency directives or advance care planning (ACP) can support decision making as can prior verbal statements. All the more important are the early clarification and structured establishment of treatment goals in line with the medical indications and patient preferences even in the emergency department. This article provides both a comprehensive theoretical framework and practical guidance for conducting treatment goal discussions in emergency settings.