Andrej Michalsen – författare

The book is primarily intended for clinicians who care for two of the most vulnerable patient subpopulations – those being treated in ambulances or emergency rooms, and those being treated at intensive care units – due in part to the fact that they may be temporarily or permanently incapacitated.

The book is primarily intended for clinicians who care for two of the most vulnerable patient subpopulations – those being treated in ambulances or emergency rooms, and those being treated at intensive care units – due in part to the fact that they may be temporarily or permanently incapacitated.

In this book, part of the European Society of Intensive Care Medicine (ESICM) textbook series, experts in the field of clinical ethics describe basic principles of clinical ethics and ethical reasoning, the fundamental pillars of intensive care medicine as well as the decision-making processes necessary to arrive at appropriate decisions for each individual patient. Specifically, the complex decision-making process, with regard to limiting life-sustaining therapies and integrating palliative care into intensive care, are expounded. Furthermore, the still controversial topics of ethical climate, proportionate care, and prioritization are elaborated upon. The so-called “soft skills” of inter-professional communication and co-operation are given the attention they deserve in order to overcome the gap between technological progress and interpersonal standstill. Finally, widely accepted ethical values and principles were challenged by the Covid-19 pandemic, forcing clinicians to elaborate recommendations regarding the prioritization of scarce resources.The book will be an invaluable tool for clinicians to understand ethical principles and reasoning to contend ethical challenges in intensive care medicine across the boundaries of disciplines and professions, in order to provide an appropriate individual plan of treatment for their patients.

In this book, part of the European Society of Intensive Care Medicine (ESICM) textbook series, experts in the field of clinical ethics describe basic principles of clinical ethics and ethical reasoning, the fundamental pillars of intensive care medicine as well as the decision-making processes necessary to arrive at appropriate decisions for each individual patient. Specifically, the complex decision-making process, with regard to limiting life-sustaining therapies and integrating palliative care into intensive care, are expounded. Furthermore, the still controversial topics of ethical climate, proportionate care, and prioritization are elaborated upon. The so-called “soft skills” of inter-professional communication and co-operation are given the attention they deserve in order to overcome the gap between technological progress and interpersonal standstill. Finally, widely accepted ethical values and principles were challenged by the Covid-19 pandemic, forcing clinicians to elaborate recommendations regarding the prioritization of scarce resources.The book will be an invaluable tool for clinicians to understand ethical principles and reasoning to contend ethical challenges in intensive care medicine across the boundaries of disciplines and professions, in order to provide an appropriate individual plan of treatment for their patients.

Der medizinisch-technische Fortschritt führt verbunden mit der demographischen Entwicklung dazu, dass immer mehr, und v.a. ältere und vorerkrankte Menschen intensivmedizinisch behandelt werden. Die Vorhersage des Behandlungsergebnisses bleibt dabei häufig schwierig. Im Verlauf einer intensivmedizinischen Behandlung geraten Ärzte und Pflegekräfte oft in ein Spannungsfeld zwischen dem, was technisch möglich ist, und dem, was dem Patientenwillen entspricht. Immer wieder wird man deshalb bei Intensivpatienten mit sehr ernster Prognose entscheiden müssen, den Therapieumfang zu begrenzen oder das Therapieziel vom kurativen Ansatz zur Symptomkontrolle und Begleitung zu verändern. Hier sind für das therapeutische Team Entscheidungshilfen und konkrete Handlungsanleitungen, basierend auf ethischen Überlegungen, dem Willen des Patienten und juristischen Regularien, hilfreich. Das vorliegende Werk beschäftigt sich u.a. mit folgenden Themen: ethische Prinzipien, juristische Grundlagen, Patientenautonomie, Entscheidungsfindung und operative Umsetzung bei Therapiebegrenzung und Therapiezieländerung, Einheit von Patient und Familie, kulturelle und religiöse Einflüsse sowie Konflikte und Burnout im Behandlungsteam. Für alle auf Intensivstationen tätigen Ärzte und Pflegekräfte, die sich mit schwierigen Entscheidungen auseinandersetzen.