Medical legal and ethical questions in palliative medicine and euthanasia.
The increasing importance of legal and ethical questions in palliative medicine and euthanasia due to the increased technical possibilities for extending life will be considered. In palliative medicine, the choice of the best therapy will be discussed, especially in the case of oncological diseases. Here, consideration of the prospects of success, for example, in chemotherapy, is faced with partly serious side-effects. The requirements of palliative medicine that the patient has to be fully informed of the fatal prognosis of his disease is equally debated as the optimum pain therapy. In this respect, the modification of the Narcotics Act of 1 February 1993 is also under discussion. In the field of euthanasia, the technical development of life extension versus dying has raised considerable legal and ethical problems regarding termination of therapy. Additionally, fiscal considerations are of increasing relevance. The common development of the legal and ethical discussion, for example, with regard to the publicity of the work of the so-called 'Gesellschaft für humanes Sterben', the public discussion leading up to a hearing of the 'Bundestag' regarding active euthanasia leads to a realization of the subject. The proposals for an active termination of life by discontinuing therapy for adults and also for malformed newborns are discussed. A dispute concerning the new legal regulation of active euthanasia in the Netherlands of February 1993 is also discussed. There, around 2% of all deaths per year result from active termination of life and also cases where persons are not able to consent. This also has enormous consequences for the position of the physician.(ABSTRACT TRUNCATED AT 250 WORDS)
Pribilla
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Institut für Rechtsmedizin, Medizinischen Universität, Lübeck, Germany.
D000328:Adult; D030881:Disclosure; D034723:Double Effect Principle; D004989:Ethics; D004992:Ethics, Medical; D005065:Euthanasia / Q000331:legislation & jurisprudence*; D028601:Euthanasia, Active; D005858:Germany; D033161:Government Regulation; D006801:Humans; D007231:Infant, Newborn; D033182:Intention; D038622:Internationality; D007603:Jurisprudence; D009369:Neoplasms / Q000628:therapy; D009426:Netherlands; D010166:Palliative Care; D018570:Risk Assessment; D017236:Suicide, Assisted / Q000331:legislation & jurisprudence; D028761:Withholding Treatment