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Living wills for hospitals often ineffective

Living wills for hospitals often ineffective

Many hospitals may not be informed about any decrees because there is no central online register. The rulings are also not part of the Electronic Health Record (Elga).

Although both the Austrian Bar Association (Örak) and the Chamber of Notaries maintain nationwide online registers in cooperation with the Red Cross, these are not linked. Örak General Secretary Bernhard Hruschka criticizes an existing legal loophole in the report: “Unfortunately, there is currently no legal obligation for hospitals or doctors to electronically query the existence of a living will.” He does not understand why the decrees are not part of Elga, although there has been a legal possibility for this since 2019. However, there must also be a way for those who have logged out of the Elga system. The chamber currently recommends those affected to always carry the order with them as a check card.

No uniform online register

The lack of a uniform online register is also criticized by the President of the Salzburg Chamber of Notaries, Claus Spruzina. As long as there are no uniform rules, hospital staff cannot be expected to gather information online themselves. In medical emergencies, there is usually no time to look at an order. “Even if the order says I don’t want to be resuscitated, it’s still usually done because the paramedic can’t check quickly.”

Isabel Rippel-Schmidjell, head of the Salzburg patient representation, criticizes the lack of an “obligation to check” on the part of hospitals and doctors. Cases in which patients received treatments that they excluded by decree, but which were carried out anyway because the doctor or hospital knew nothing about a decree, but neither she nor Örak or the Chamber of Notaries are aware of them.

concept is available

According to “SN”, the Ministry of Health said that Elga GmbH was commissioned to implement the electronic living will and that funding from the federal government was already secured. An implementation concept is now available, and work is currently underway on adapting the corresponding legal basis, as both the Patient Will Act and the Health Telematics Act need to be amended. The implementation is planned in such a way that participation in ELGA is not a requirement.

This should come in the course of 2024. All living wills created from this point onwards should then be available online, but this does not apply to existing ones, since “the required data quality cannot be ensured,” according to the ministry.

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