Are "Ethics Guidelines" helpful in taking critical treatment decisions? A comparative casuistic analysis of German, British, and Swiss Guidelines regarding Palliative Care

Definition of the problem: Decisions concerning treatment limitation and Palliative Care are often complex and accompanied by ethical problems. The crucial question is analyzed as to how helpful existing "Ethics Guidelines" actually are in clinical practice that should offer ethical orientation for decisions about treatment limitation and Palliative Care. The question of what benefit "Ethics Guidelines" give or can give when trying to take a decision, is analyzed in an exemplary way by taking a clinical case study from a collaborative Ethics Study in Intensive Care. "Ethics Guidelines" from Germany, Switzerland, and Great Britain that were the subject matter of a project analyzing international Guidelines are applied to the case and compared. Arguments: The possibilities and limitations of "Ethics Guidelines" in offering ethical orientation regarding problems of decision making about treatment limitation and in Palliative Care are discussed and illustrated in the case study. Conclusion: Finally, conclusions are drawn for the future development of ethical guidelines for clinical practice. © Springer Medizin Verlag 2005