[Medical-ethical decision-making-contribution of the clinical ethics committee by ethics consultation and development of ethical guidelines].

Medical-ethical decision-making ranges between the poles of the medical indication on the one hand and the will of the informed and advised patient on the other, which do not necessarily have to coincide. Even if the definitive choice of action is made by the attending physician/the treatment team, it is particularly helpful in problematic conflicting situations to set up the corresponding decision-making as broadly as possible, with the result that ultimately an appropriate, acceptable, and well-founded decision is made for all parties involved. The clinical ethics committee (CEC) can perform the task of providing the most comprehensive and structured support possible in decision-making and problem-solving in a medical-ethical context with all its instruments of ethics consultation as well as by the development of "ethical guidelines". The CEC is not a decision-making body that makes unilateral decisions on its own authority and relieves the directly treating persons of the decision-making responsibility, but an advisory and supporting authority. For recurring, similar ethically sensitive questions, ethical guidelines can be created by the CEC of an institution with the aim of facilitating decision-making in a corresponding ethical problem situation. An ethical guideline provides orientation that can increase the quality of decision-making and relieve decision-makers ethically and legally. In doing so, the ethical guideline grants the decision-maker a range of possibilities by specifying a meaningful corridor for action, from which, in justified cases, deviations can also be made after individual evaluation.