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Precautionary powers and living wills are often too inaccurately formulated
In a living will, persons can give instructions to the doctor in case they are no longer able to make decisions or are unable to express themselves. However, a recent study shows that these injunctions are often inaccurately formulated. In addition, many intensive care patients have neither a living will nor a precautionary power.
Only about half of the intensive care patients have a living will
Although the number of precautionary powers and living wills is steadily increasing throughout Germany, only about half of the patients in the intensive care unit (51.3 percent) still have one of the two documents. This is what scientists from the University Medical Center Hamburg-Eppendorf (UKE) found out in a study published in the "Deutsches Ärzteblatt".
Only about half of the ICU patients have a living will or prevention order. In addition, the forms are often filled in incorrectly. (Image: Ralf Kalytta / fotolia.com) Forms are often filled in incorrectly
Specifically, 38.6 percent of patients have a precautionary power and 29.4 percent have a living will, the UKE reported in a statement.
However, 39.8 percent of the given pension plans and 44.1 percent of the issued living wills were hard to interpret due to incorrect completion of forms.
Ambiguities on such letters repeatedly cause misunderstandings or misinterpretations. These also sometimes employ the German courts.
For example, the Federal Court of Justice (BGH) had stated in a judgment that the rejection of "life-prolonging measures" as formulation was not concrete enough.
Fear of lack of self-determination and medical over-therapy
Prof. Dr. Stefan Kluge, Director of the Clinic for Intensive Care Medicine of the UKE, criticized: "Too few patients still have a power of attorney or a living will."
He explained: "The personal conversation between doctor and patient or relative is therefore still the most common way to determine the patient's will. However, even close relatives often are unable or unwilling to reproduce the actual patient's will. "
"This dilemma can only be solved by creating a living will and a power of attorney", says Prof. Kluge.
According to the study, elderly and electively admitted patients are more likely to have a precautionary power or living will. Almost half (48 percent) of patients with existing documents had filled them out for fear of being at risk, lack of self-determination, or medical overtreatment.
Despite these fears, however, few patients seek help from a doctor; Only 15.4 percent of patients with documents completed them after receiving medical advice. Half of the patients without documents (50.4 percent) had at least already thought about a preparation.
The living will should be formulated specifically
For the study, the scientists sampled a total of 998 patients at eleven wards of the UKE's intensive care unit shortly before they were transferred to a normal ward and evaluated their data.
With a living will, patients can give instructions to the doctor in case the patient is no longer able to make decisions or can not comment. The order must include a decision to consent or not to consent to a specific, not yet imminent, medical action.
With a precautionary power of attorney, confidants can be selected who, if necessary, will carry out individual or all legal transactions according to predetermined wishes and needs. By creating a preventive power of attorney a legal care in an emergency can be avoided.
"A living will or prevention mandate should be specifically formulated and delivered to the hospital when admitted. We recommend that you seek advice from a physician when making a living will. " Geraldine de Heer from UKE. (Ad)