Quality of life in burn victims: a holistic approach

The prognosis of burn patients is dependent--apart from adequate treatment--upon health care system and health care professionals, regarding not only survival, but also life-long quality of life. The protection of patients' rights is spelled out in the European Countries' constitutions, charters or basic laws. The Code of Patients' Rights in the Czech Republic in 1992 entitles the patients to respectful and professional treatment, to be able to make decisions, ev. to refuse treatment, to the presence of their own families, to continuity of treatment after discharge, to withhold consent to students' participation in the curative process, to die with dignity. The increasing interest in economic justification of any treatment in the EU calls for considering the ethical aspects. There has been differentiated intuitive ethics, ethics based on principles of Hippocrates, ethics defined by duties, ethics defined by consequences, influencing the quality of life (Grant, 1998). The age of patients should not play any role in decision--making concerning diagnostic or curative procedures. However, in geriatric burn patients the "aggressive" therapy should not deteriorate their last days. From the ethical point of view there should be applied "palliative care". The age is a significant factor in the permanent sequels in children and youngsters, in whom scar deformities cause the loss of "body image" and severe psychological problems when the Patients Rights (comprehended in the Code of Czech Republic) are not respected.