Ethik und Palliativmedizin in Intensiv- und Beatmungsmedizin

Ethics and palliative care have a growing impact at the present time. This is true not only in oncology but also increasingly more for intensive care medicine and home mechanical ventilation. In particular, the large number of invasively ventilated patients with weaning failure has led to a clear focus on this both life-sustaining and possibly undesired life-prolonging treatment. In addition to what is technically feasible, the perspectives of patients and their families are coming more into focus. Palliative care skills are needed to elicit and adequately react to the patient’s wishes, even if that leads to therapy withdrawal or withholding treatment. Changing the aim of the treatment is becoming increasingly more important. In the non-clinical area of home mechanical ventilation the establishment of palliative care structures for chronically critically ill patients mainly suffering from dyspnea are crucially needed. Early intervention in and counseling of patients with chronic diseases is helpful in avoiding futile long-term invasive mechanical ventilation.