Ethical Case Discussions in Family Medicine: A Practice Guidance
DOI: 10.3238/zfa.2018.0116-0120german translation / full article
Abstract: Over the last years, ethical consultation services have been increasingly implemented also in the ambulatory care sector in Germany. Support for difficult ethical decisions is usually offered in structured ethical case discussions, guided by a moderator with specific training. Representatives from all professional groups involved in the care of the patient are invited to join these discussions, in particular the family practitioner and the responsible nurse, as well as the closest family member(s) if so desired by the patient or if the patient has lost decision making capacity. This article presents a model to structure ethical case discussions which bases the evaluation on the four classical principles of biomedical ethics: beneficence, non-beneficial effects, respect for autonomy and justice. This principle-based case discussion can be used both for the moderation of ethical case discussions in the inpatient and outpatient care setting and by family practitioners as guidance for the structured workup of difficult ethical decisions.