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Germany

German Government to Strengthen Patients' Right to Die

Germany's justice minister wants to make it easier for terminally ill patients to refuse life-extending treatments in the hospital. A bill has been introduced which would add legal weight to patients' wishes.

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A new bill would make living wills the final word in medical treatment

The federal government is not aiming to legalize active medically assisted suicide, according to Justice Minister Brigitte Zypries, rather it is seeking through the bill it introduced on Thursday to put patients' own decisions on medical treatment, especially regarding artificial life support, on more secure legal ground.

The law proposed by the Social Democratic minister would add heft to so-called advance health care declarations, or living wills, made by patients who ask that their lives not be extended by artificial means. It would also give doctors and patients' relatives a more secure legal footing when carrying out patients' wishes.

The bill, which if passed would become law in 2006, is based on suggestions made by a working group the minister convened called "Patient Autonomy at the End of Life." Headed by a former federal judge, the group included doctors, legal experts, social welfare groups and churches.

The group came together after a federal court ruling in March 2003 in which judges acknowledged the relevance of living wills, but ruled that in the event of a disagreement between an attending physician and the custodian of a comatose patient, the matter had to be referred to a guardianship court, which would decide whether, for example, removing a feeding tube would be in the best interests of the patient.

According to Zypries, under the new law the guardianship would no longer be consulted if a living will has designated a person to represent a patient's wishes should he or she no longer be able to. That representative would then be able to make decisions based on the contents of the living will. Additionally, the living will should in the future have legal weight in any stage of illness, not only when the patient's condition has become terminal.

The head of the working group which drafted the bill, Federal Judge Klaus Kutzer, said the proposed law is not active assisted suicide or the so-called death on demand, in which a lethal drug is administered to a patient. He said the working group did not want to create any legal room for such actions with the proposed law, but did want to create a legal framework in which passive doctor-assisted suicide was possible for patients who wanted it.

Slippery slope criticism

But the minister's proposal drew criticism from churches, the German hospice association, the Federal Doctors' Chamber and the conservative Christian Democratic Union (CDU), who said it was a first step in legalizing active medically assisted suicide. Hubert Hüppe, deputy head of the German parliament's ethics commission and CDU member, warned against "unusually dangerous tendencies" toward weakening laws that protect the lives of patients. Both the Protestant and Catholic churches of Germany said patients "should not in any instance be put under pressure" to end their lives.

Justice Minister Zypries encouraged Germans to put some thought into what they would want should they be incapacitated by a serious illness or accident and to consider drawing up a living will.

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