MMW Fortschritte der Medizin
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In Germany, the legal possibilities for withholding or withdrawing life-preserving measures are based on four judgments by the Federal High Court, which forbid both the deliberate killing of a patient and physician-assisted suicide. Life-saving measures may be withheld or withdrawn only when this is in conformity with the declared will of the patient (as expressed, for example, in a living will, or by the patient's proxy), and when death is to be expected within the near future. If the process of dying has already begun, such a decision may be taken even when the expressed will of the patient is not known.
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The medical possibilities of keeping a patient alive with the aid of drugs and technical aids are constantly expanding. A more difficult decision that the care-providing physician is called upon to make is: when is the point reached when further treatment no longer makes sense? From here on, the objective is to enable the patient to die with dignity,which entails allowing him/her and relatives the opportunity to take their leave of one another.
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An international comparison reveals considerable differences in the legal constraints imposed upon a physician in his approach to the question of euthanasia and physician-assisted suicide. Despite the fact that surveys show 50-80% of the German population to be in favor of active assistance for terminally-ill patients wishing to end their lives, in 2004 the Bundesärztekammer (Federal Medical Association) confirmed its earlier rejection of active euthanasia and assisted suicide. Instead, Germany favors palliative medical measures that enable those whose death is imminent to take their leave with dignity.