Abstract

Burns injuries affect 10 000 people annually in the UK and of these 650–700 die. Many who would have previously died now survive as the treatment of burns patients improves. Ethical dilemmas may occur when decisions need to be made about the treatment of incompetent patients. These decision may concern the initiation, continuation or termination of treatment. The ethical principles of autonomy, beneficence, non-maleficence and justice are described and how their application allows, both morally and legally, the initiation and termination of treatment, even when the patient cannot be involved in the decision. The debate surrounding advance directives which would give the patient some control over what was done to him when incompetent to make decisions and euthanasia are reviewed.

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