[Validation of medical ethical decisions at the bedside by the autopsy : Experience of the ethics committee at the Stuttgart Clinic].

BACKGROUND: Ethics consultations in a clinical setting can be challenging, specifically with respect to limiting therapeutic interventions in terminally ill patients. Some decisions will even be controversial.

OBJECTIVE: Can a clinical autopsy be used to confirm the recommendations given by the ethics committee, i. e. limitation of therapy to palliative care?

MATERIAL AND METHODS: We report an exemplary case of a patient with endocarditis and subsequent septic cerebral infarction. During treatment in the intensive care unit (ICU) two ethics consultations were held. Both times the patient' s clinical condition and prognosis were controversially discussed. The patient died after a recommendation had been given for supportive care. The subsequent autopsy, which is described in detail, confirmed a fatal set of symptoms with extensive destruction of the heart and disseminated brain infarcts.

CONCLUSION: Clinical autopsies are crucial for an objective description of diseases and can corroborate the decision to limit therapeutic intervention in end of life care. It is a valuable tool in evaluating the quality of decision making in ethics counseling.