Ethical criteria for judging a palliative therapy goal in intensive care medicine

Definition of the problem Current policy papers such as the document of the section Ethics of the German Interdisciplinary Association of Critical Care and Emergency Medicine "Changing therapeutic goals and limitation of treatment in intensive care medicine", the "Munich policy on end-of-life decisions", and the "Guidelines on the limitation of treatment in intensive care medicine" of Erlangen focus on the reasoning and conception of practical decision-making processes. The formal ethical reasons for changing therapeutic goals on the basis of medical indications have been discussed to a far lesser extent. They are based on a justified definition of a realistically achievable goal ending up in therapeutic pathways. Based on a decision-making situation in intensive care medicine, the text wants to show that an Aristotelian argumentation plays an important role in the case of changing a therapeutic goal based on the medical indication. As a result, clinical ethics consultation cannot only focus on the meaning of principles in terms of content but also has to emphasize the knowledge of formal estimation of acts.