[Intercultural competence. Management of foreignness in intensive care medicine]

[Intensive care and emergency medicine overuse and sustainability]

This review examines the issue of overtreatment and overdiagnosis in the context of intensive care and emergency medicine and its relationship to sustainability. It shows that the intensive use of resources, both human and technology, is often associated with risks of overuse, especially in critical medical situations. More diagnostic and therapeutic measures are often taken than necessary, leading to both stress for the patient and a high consumption of resources. One of the main problems is the often difficult distinction between necessary and excessive treatment. Uncertainty in acute care, coupled with legal concerns, often leads to defensive medicine. This means that, for safety reasons, physicians initiate more diagnostic tests and treatments than are clinically necessary. There are also economic disincentives in the healthcare system that encourage overtreatment. The paper also discusses the role of guidelines, particularly with respect to patient preferences. These can help to avoid unnecessary admissions to the intensive care unit and thus contribute to sustainability. The discussion shows that sustainability should not be at odds with high-quality patient care. Rather, treatment options should also be considered in terms of their contribution to sustainability, without neglecting the individual needs of patients.