title: [Ethical aspects of palliative medicine].
abstract: BACKGROUND
  The aim of palliative medicine is to adequately care for and attend to patients suffering from life-threatening and incurable medical conditions according to their needs. This implies that for these patients it is not a matter of dealing with diseases that can be treated separately but with their existence in the face of their approaching death.
  
  
  OBJECTIVE
  This article investigates which ethical questions are currently prioritized for discussion in palliative medicine.
  
  
  METHODS
  Review of the current medical and ethical literature and own reflections with a relational ethics approach that puts patient wishes at the centre of attention.
  
  
  RESULTS
  Palliative medicine is not a "luxury medicine" but has to be considered as primary care to which every person is entitled. If there is a need for improvement of care, promoting it is an ethical obligation. In this respect the question of a "good death" is extremely complex. The term is connected to the ethics of a good life and includes the dimensions of happiness-suffering as well as meaning-futility; therefore, the best possible treatment of symptoms, most of all pain is just as important as recognizing subjective questions of meaning. Dealing with the wishes of patients, including possible wishes to die, are the starting point for elaborating palliative care measures. It is concerned with finding the right point in time for each patient individually, in their best interests and according to their wishes, at which dying should no longer be held back but for their own benefit the patient should be accompanied and supported during dying.
  
  
  CONCLUSIONS
  In the current construction of palliative medicine, including its normative configuration within the law and medical ethics, the criteria which are essential for the quality of life up to death are being discussed.
authors.affiliation: Institut für Medizingeschichte und Wissenschaftsforschung, Universität zu Lübeck, Königstr. 42, 23552, Lübeck, Deutschland. rehmann@imgwf.uni-luebeck.de.
authors.forename: C
authors.initials: C
authors.lastname: Rehmann-Sutter
authors.affiliation: Medizinische Klinik I, Universitätsklinikum Schleswig-Holstein, Lübeck, Deutschland.
authors.forename: H
authors.initials: H
authors.lastname: Lehnert
mesh_terms: D001293:Attitude to Death; D002908:Chronic Disease / Q000523:psychology / Q000628:therapy*; D033101:Euthanasia, Active, Voluntary / Q000941:ethics*; D019317:Evidence-Based Medicine; D005858:Germany; D006801:Humans; D010166:Palliative Care / Q000941:ethics* / Q000523:psychology; D065126:Palliative Medicine / Q000941:ethics*; D010342:Patient Acceptance of Health Care; D010819:Physician's Role; D013727:Terminal Care / Q000941:ethics* / Q000523:psychology; D019452:Terminally Ill / Q000523:psychology; D028761:Withholding Treatment / Q000941:ethics*
keywords: Bioethics; End of life care; Ethics, medical; Quality of life; Wish to die