文摘
Background Despite established structures for clinical ethics consultation, emergency medical professionals continually face problems when making decisions about life-prolonging procedures either in the emergency room or already in the preclinical setting. A particularly difficult decision is that of resuscitation with and without existing advance directives. Culmination points of such decisions are the emergency rooms. Methods The working group Ethics in Emergency and Acute Medicine of the DGINA (German Association of Interdisciplinary Emergency and Acute Medicine) conducted a survey among DGINA members about how this problem is handled in emergency departments. Results Of the emergency medicine professionals replying, 58.2- see problems when dealing with resuscitation and 48.7- when dealing with advance directives. In the opinion of 50-, the reaction to this problem is often adequate. A clinical ethics committee is considered very useful or advisable by 73.4-, but in only 7.3- of the responders had a clinical ethics committee visited the emergency room. Written decision aids for such situations in the emergency room were considered reasonable by 71.2- of the responders. Discussion The result shows a remarkable sensitivity to the subject among the survey participants, but also the awareness that established structures of clinical ethics consultation, such as ethics committees or ethics councils, do not work here. Nevertheless, the desire for ethical support in such situations, for example by written recommendations, is expressed in the survey, which is a focus area of the working group for Ethics in the Emergency and Acute Mmedicine of the DGINA. The survey illustrates how German emergency departments deal with this problem, thus, confirming and supplementing the contemporary literature.