scholarly journals Can there be wrongful life at the end of life? German courts revisit an old problem in a new context

2020 ◽  
Vol 46 (5) ◽  
pp. 348-350
Author(s):  
Ulrich Pfeifer ◽  
Ruth Horn
Keyword(s):  
End Of Life ◽  
Medical Decision Making ◽  
Federal Court ◽  
Value Of Life ◽  
Medical Professional ◽  
Medical Decision ◽  
Wrongful Life ◽  
Legal Questions ◽  
Life Sustaining Treatment ◽  
Nutrition And Hydration

This article discusses a recent ruling by the German Federal Court concerning medical professional liability due to potentially unlawful clinically assisted nutrition and hydration (CANH) at the end of life. This case raises important ethical and legal questions regarding a third person’s right to judge the value of another person’s life and the concept of ‘wrongful life’. In our brief report, we discuss the concepts of the ‘value of life’ and wrongful life, which were evoked by the court, and how these concepts apply to the present case. We examine whether and to what extent value-of-life judgements can be avoided in medical decision-making. The wrongful-life concept is crucial to the understanding of this case. It deals with the question whether life, even when suffering is involved, could ever be worse than death. The effects of this ruling on medical and legal practice in Germany are to be seen. It seems likely that it will discourage claims for compensation following life-sustaining treatment (LST). However, it is unclear to what extent physicians’ decisions will be affected, especially those concerning withdrawal of CANH. We conclude that there is a risk that LST may come to be seen as the ‘safe’ option for the physician, and hence, as always appropriate.

scholarly journals Family Matters: Dyadic Agreement in End-of-Life Medical Decision Making

2009 ◽  
Vol 50 (2) ◽  
pp. 226-237 ◽  
Author(s):  
B. Schmid ◽  
R. S. Allen ◽  
P. P. Haley ◽  
J. DeCoster
Keyword(s):  
Decision Making ◽  
End Of Life ◽  
Medical Decision Making ◽  
Medical Decision

scholarly journals Preferences on the Timing of Initiating Advance Care Planning and Withdrawing Life-Sustaining Treatment between Terminally-Ill Cancer Patients and Their Main Family Caregivers: A Prospective Study

2020 ◽  
Vol 17 (21) ◽  
pp. 7954
Author(s):  
Cheng-Pei Lin ◽  
Jen-Kuei Peng ◽  
Ping-Jen Chen ◽  
Hsien-Liang Huang ◽  
Su-Hsuan Hsu ◽  
...  
Keyword(s):  
Family Caregivers ◽  
Advance Care Planning ◽  
Medical Decision Making ◽  
Terminally Ill ◽  
Medical Decision ◽  
Care Planning ◽  
Terminally Ill Cancer Patients ◽  
Life Sustaining Treatment ◽  
Advance Care ◽  
A Prospective Study

Background: The Western individualistic understanding of autonomy for advance care planning is considered not to reflect the Asian family-centered approach in medical decision-making. The study aim is to compare preferences on timing for advance care planning initiatives and life-sustaining treatment withdrawal between terminally-ill cancer patients and their family caregivers in Taiwan. Methods: A prospective study using questionnaire survey was conducted with both terminally-ill cancer patient and their family caregiver dyads independently in inpatient and outpatient palliative care settings in a tertiary hospital in Northern Taiwan. Self-reported questionnaire using clinical scenario of incurable lung cancer was employed. Descriptive analysis was used for data analysis. Results: Fifty-four patients and family dyads were recruited from 1 August 2019 to 15 January 2020. Nearly 80% of patients and caregivers agreed that advance care planning should be conducted when the patient was at a non-frail stage of disease. Patients’ frail stage of disease was considered the indicator for life-sustaining treatments withdrawal except for nutrition and fluid supplements, antibiotics or blood transfusions. Patient dyads considered that advance care planning discussions were meaningful without arousing emotional distress. Conclusion: Patient dyads’ preferences on the timing of initiating advance care planning and life-sustaining treatments withdrawal were found to be consistent. Taiwanese people’s medical decision-making is heavily influenced by cultural characteristics including relational autonomy and filial piety. The findings could inform the clinical practice and policy in the wider Asia–Pacific region.

Informed Consent and Advance Directives

2004 ◽  
Vol 94 (2) ◽  
pp. 198-205
Author(s):  
Jay M. Baruch
Keyword(s):  
Decision Making ◽  
Informed Consent ◽  
End Of Life ◽  
Advance Directives ◽  
Medical Decision Making ◽  
Informed Decision ◽  
Ethical Framework ◽  
Medical Decision ◽  
Informed Decision Making ◽  
Popular Belief

Contrary to popular belief, a patient’s signature on a piece of paper does not constitute informed consent. This article describes the ethical framework of consent in the context of the larger process of informed decision making. The elements of informed consent are examined in practical terms. Common pitfalls are addressed, with strategies to help anticipate and resolve possible dilemmas. These important tools are integral to all levels of medical decision making, including those at the end of life. (J Am Podiatr Med Assoc 94(2): 198-205, 2004)

End-of-life medical decision-making for children in custody: A collaborative, multi-stakeholder practical approach

2020 ◽  
Vol 103 ◽  
pp. 104441
Author(s):  
Ricki S. Carroll ◽  
Eliza Hirst ◽  
Mark Hudson ◽  
Molly Shaw ◽  
Stephanie A. Deutsch
Keyword(s):  
Decision Making ◽  
End Of Life ◽  
Medical Decision Making ◽  
Practical Approach ◽  
Medical Decision ◽  
Multi Stakeholder

Imagining the End of Life: On the Psychology of Advance Medical Decision Making

2005 ◽  
Vol 29 (4) ◽  
pp. 475-496 ◽  
Author(s):  
Peter H. Ditto ◽  
Nikki A. Hawkins ◽  
David A. Pizarro
Keyword(s):  
Decision Making ◽  
End Of Life ◽  
Medical Decision Making ◽  
Medical Decision
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