Zentralblatt für Chirurgie
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Since the Federal High Court decided the "Case of Kempten" in 1994, German Law allows discontinuation of life-sustaining treatment even when the patient's life could be extended by a number of months. Unfortunately, the court gives little normative criteria regarding the conditions under which "helping to die" is legal. ⋯ Therefore, the legal problems have shifted to the determination of the patient's will and substituted consent; written living will, power of attorney and consent of the court have become more important within the law of euthanasia. Along with a general description of the legal limits of euthanasia, the scope of application of these civil law institutes will be discussed.
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Medical treatment requires more than the application of techniques and devices. Knowing the limitations of (intensive) care and respecting patients' will and dignity is as important as technical skills. Limitations of therapy may arise from medical, ethical, legal, and economic reasons. ⋯ The patient and/or his family, all attending physicians and the nursing staff have to agree when limitation of care is taken into account. Hospital guidelines and written orders will help physicians and nursing staff to manage these difficult situations. Whether treatment has been limited or not, the patient and his family deserve all our medical and psychological skills--until the end.