Ethische Entscheidungsmuster in der Chefetage: Im klinischen Dilemma zwischen Optimum und Maximum

Background. Before a medical intervention is carried out, decisions must be made on the proposed optimal medical procedure. Especially in complex decision situations the treatment team is itself often uncertain about the optimal decision.

Objectives. This explorative interview study tries to analyze the question how head physicians, being responsible for the treatment team, make difficult ethical decisions and what they consider to be a good decision.

Material and methods. Exploratory interviews were conducted with head physicians that were analyzed from a phenomenologically oriented point of view. Results. In this study four different types of decision-making could be identified: head physicians either try to support decisions through an already existing standardized recommendation (a), consensus is sought within the team(b), decisions are based on own values (c) or a solution is specified in an autonomous 'military' way (d).

Conclusion. The following points of discussion arose: the process of making decisions is not the same as the result of the decision. Our pluralistic, western lifestyle no longer allows us to try to impose on others what exactly a good decision is; however, the forms of justificationon which these decisions are based can be examined.