1.2.29 Establishment of an ethics consultation and ethical case discussion

Goal and purpose

The task of the committee is to provide advice and recommendations to doctors, nursing staff, but also to patients, their representatives (carers) and next of kin in ethically relevant medical and nursing decisions in borderline situations involving seriously ill patients.
The programme should include the offer of an ethical case discussion.

Application

Ethical issues that do not fall within the remit of federal or state ethics committees.

The Ethics Consultation is an offer of counselling. There is no obligation to seek counselling.

The dialogue offered by the Ethics Consultation is also aimed at those treating physicians who want to gain more clarity about the necessary and ethically justifiable therapeutic measures, as may be the case with individual treatment attempts, for example, if the standard therapy does not (or no longer) promise sufficient success.

Description of the process

The patient's right to self-determination is at the forefront of treatment, or the will of the parents in the case of incapacitated children. However, the wishes expressly expressed by the patient, which may already be documented in a so-called living will, can expose the medical and nursing staff involved in the treatment and care of the patient to an ethical conflict, in the resolution of which an external counselling body can be helpful. Patients who reject a certain type of treatment themselves or - in the case of children - through their parents for reasons of faith and ethical questions in connection with end-of-life care should also be considered.

Principles governing the activities of the Ethics Council

1. The hospital's ethics committee has the task of advising and making recommendations in medical borderline cases between life and death, as well as dealing with ethical questions arising from individual treatment cases and proposing solutions.
2. The Ethics Committee is convened at the request of the doctors and nursing staff involved with a patient, as well as the patients themselves, their representatives and next of kin. Referrals to the Ethics Committee are made on a voluntary basis. The recommendations made or the results of the consultation are not binding for the doctors and nursing staff involved in the clinical treatment.
3. The ethics committee consists of: 2 doctors, 1 nurse, 1 counsellor and 1 lawyer. The doctors and nursing staff on the ethics committee must not be involved in the treatment of the patient. The members of the ethics committee are appointed by mutual agreement between the Medical Director and the Nursing Director.
4. The meetings of the Ethics Committee are not open to the public. The Ethics Committee is free to invite other persons to attend or to authorise them to attend the meeting.
5. Minutes must be taken of the meetings, which reflect the results of the discussions. In the event of differences of opinion, the divergent opinions must be noted.
6. The results of the counselling must be communicated in an appropriate form to the doctors and nursing staff involved in the treatment. As far as possible, the patient themselves, their representative and the next of kin must be familiarised with the discussion process. There is no right to inspect the recorded consultation results.
7. The Ethics Committee may not deal with cases in which the Central Federal Ethics Committee, the ethics committees at federal state level and the committee pursuant to Section 8 (3) of the Transplantation Act are responsible, nor in cases in which recourse to a court is required.

The following members were appointed to the consilium:

Responsibility

Medical decisions and responsibilities for patients remain unaffected by this counselling.

The ombudsman is the coordinator of the committee. Those seeking advice can contact the coordinator by telephone (Tel.: -). The committee endeavours to offer a counselling appointment within 3 - 4 days.

Documentation

Minutes must be taken of the meetings, which reflect the results of the discussions. In the event of differences of opinion, the divergent opinions must be noted.

Notes and comments

Terms

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