Einleitung und Abbruch der künstlichen Ernährung beim einwilligungsunfähigen Patienten

Definition of the problem: In Austria the legal discussion on initiating and withdrawing artificial nutrition in incompetent patients has just begun. Arguments and conclusion: Legal regulations are lacking, but there appears to be agreement on accepting advance directives under specific criteria. This would mean that a presumed will and documented refusal of treatment and nutrition has to be respected by physicians. However, there is no consensus with regard to the “supposed will” of an incompetent patient to refuse treatment and nutrition. At present, surrogate decision making with regard to refusing life-sustaining treatment or nutrition is only accepted according to a declared and documented directive of the patient himself. When the patient’s will has to be “surmised” the protection of life has priority. In Austria this concept is based on the national constitution and its duty to protect life.