[Human dignity and autonomy in medicoethical decisions at the end of life].

Autor: Derler F; Klinik für Palliativmedizin, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 305, 69120, Heidelberg, Deutschland. Florian.Derler@med.uni-heidelberg.de.
Jazyk: němčina
Zdroj: Zeitschrift fur Gerontologie und Geriatrie [Z Gerontol Geriatr] 2024 Nov; Vol. 57 (7), pp. 550-555. Date of Electronic Publication: 2024 May 14.
DOI: 10.1007/s00391-024-02308-1
Abstrakt: Respect of human dignity is an unquestionable part of daily clinical routine as well as of evaluations in medical ethics. Some aspects of human dignity are a subject of transformation in the course of a lifetime. If the ability to form a will is reduced, it might be difficult to satisfy the individual perception of a dignified treatment, which is of particular interest in terminal care. As illustrated by the presented case report, moral problems can arise when the patient's present verbal or non-verbal expressions are opposed to what is documented or what is estimated by dependants to be the individual's will. In clinical decision-making processes, the determination of the will via an advance directive can be overstated, which can go so far that human dignity is reduced to autonomy. A concept of dignity reduced to autonomy misses the point not only of a dignity-centered medical care but also of shared decision-making. In situations at the end of life other aspects, such as authenticity or self-actualization should be considered when respecting the individual's dignity. Medicine should as such not marginalize death but provide a care based on principles that focus on human interaction and respect for a comprehensive concept of dignity.
(© 2024. The Author(s).)
Databáze: MEDLINE
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