Ethical and legal aspects of the transition from intensive to palliative care in the context of the Czech Republic
Abstract
Deciding not to initiate or discontinue intensive care is one of the most difficult decision-making at the end of life, despite the generally accepted view that some treatment brings more suffering than benefit to the patient. Many patients affected by this decision are no longer able to express their views and previously expressed wishes cannot be respected if they lead to an end of organ support and, in accordance with the Act on Health Services, an active cause of the patient's death.
The aim of the contribution is to bring closer the ethical and legal aspects of the given issue, whose reflection can help in decision making process. Significant documents are the Consensual Opinion on Providing Palliative Care to Patients with Irreversible Organ Failure and the Recommendation of the Board of Directors ČLK 1/2010.
While these recommendations are not legally binding, they are (as the legislation on this subject) reflecting the most fundamental ethical principles - human dignity, beneficence, nonmaleficence, autonomy, justice and vulnerability, and in the case of criminal liability for termination of intensive care would play a major role.