Spiritualität und Medizin
Grenzen der Selbstbestimmung am Lebensende: Die Patientenverfügung als Patentlösung?
Dying from »natural« causes is not appreciated in Western industrialized countries because it may be regarded as an obstacle against performance and consumption. In addition, life-saving therapies for patients with an adverse prognosis are often rather expensive and therefore classified as »futile«. Utilitarian measures for the individuals quality of life (QALYs), which are allegedly objective, obscure the fact that they can only reflect those parameters which were actually considered when the measures were devised. Caused by fear of a life in a nursing home, partially intensified by media reports, many ethicists and lawyers argue in favour of so-called anticipating models of retaining ones autonomy at the end of life. Apart from general considerations published by the former National Ethics Council in 2005, the German Parliament in 2009 will have to discuss three different bills concerning patients advance directives to refuse medical treatment. On the basis of an example taken from clinical ethics consultation we argue that already today a patients advance directive to refuse medical treatment and a person with the power of attorney can have fatal results if such a person acts arbitrarily and not in the intrerest of the patients autonomy. The illusion of »autonomous dying« is not a convincing model in the debate about the end of life.Zum vollständigen Artikel | Artikel bestellen