Fine vita e decisioni etiche nelle emergenze anestesiologiche intraospedaliere.

Biomedical and biotechnological progress nowadays allowed doctors to prolong life through new and best therapies for many, once deathly, illnesses, and through new machine which can maintain vital functions in an artificial way; the therapeutic limit is always moved forward. Anesthesiologist usually manage emergency and urgencies in all hospitals’ ward where the patients, especially during night and festive shift, can’t always refer to their daily practitioner, who is not present in those context. If a CPR is necessary without the presence of the daily practitioner, bioethical problems, most of all due to the lack of medical deliveries regarding end of life decisions and clinical problems, grow exponentially. These conditions often lead to a wrong management with a start or a prosecution of treatments even when there shouldn’t have been a proper indication; with a good communication and time to study the case, no one would have probably started CPR in many of those patients. Our goal was the evaluation of the management of these special cases, in a bioethical field, by visualizing retrospectively one year of intrahospital emergencies with an anaesthesiologist call, looking for basal datas regarding number and typology of emergencies and what is normally reported in medical records, then following results of these patients. Surely we can conclude that, if we want an improvement regarding ethical approach to CPR to patients with clinical history unknown by anesthesiologist, there should be a more codified decisional flowchart or medical delivery system in order to write and tell clearly ethical and clinical consideration.