End-of-life care

The progress of modern medicine has substantially increased life expectancy and improved the quality of life. However, the possibility of the medical treatment of disease, the reduction of suffering and the prolongation of life may become a burden if the full panoply of high-technology intensive care is deployed in such a way that measures to prolong life are taken even at the cost of pointless drawing out of the process of dying and the imposition of suffering. Many people manifestly fear that such a fate might await them at the end of their lives and would prefer a non-lingering death without dependence on technical apparatus. It is precisely this ambivalence that makes the subject-matter of this Opinion so important. After all, now that conscious intervention in the process of dying is possible and indeed unavoidable, matters such as the taking of difficult and conflictual decisions in borderline situations at the end of life cannot be eschewed.

Dying is an individual process which, as such, cannot be removed from the sphere of the individual’s self-determination. At the same time, however, it involves a range of different ethical obligations, legal demands and religious expectations, which call for thorough discussion and evaluation in all their aspects.

The National Ethics Council has intensively discussed the issues involved in dealing responsibly with dying. It has perused a large volume of material, obtained expert opinions, consulted with doctors and other medical specialists, and held meetings in Augsburg and Münster at which it exposed itself to public debate. The outcome is enshrined in the Opinion now presented.

The Opinion "Self-determination and care at the end of life" continues the examination of the themes addressed in the Opinion "The advance directive" published in June 2005. The present analysis, in conjunction with the clarification of terminology here proposed, may facilitate interpretation of the recommendations set out in that Opinion.

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