The ongoing discussion on termination of life on request. A review from a German/European perspective

Möller, Hans‐Jürgen

doi:10.1080/13651501.2020.1797097

Cited by 9 publications

(13 citation statements)

References 55 publications

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“…Society includes all comments on juridical aspects of palliative care, cultural conventions and societal attitudes towards death, dying and end of life care (specifically on 'assisted Table 1. Eleven domains of the semi-structured clinical approach as originally presented in Kremeike, 2020 [14]. suicide'), norms and ethical values.…”

Section: Thematic Categoriesmentioning

confidence: 99%

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“Withstanding ambivalence is of particular importance”—Controversies among experts on dealing with desire to die in palliative care

et al. 2021

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In order to investigate controversies surrounding the desire to die phenomenon in palliative care by analyzing expert opinions on the topic, we carried out a secondary qualitative data analysis of free text comments collected during a Delphi survey that was designed to develop a conversation aid for dealing with desire to die in everyday clinical practice. Between 01/2018 and 03/2018, a two-round Delphi survey was carried out with national (German) and international palliative care experts. Free text comments were reinvestigated to identify controversies surrounding the desire to die phenomenon. An additional in-depth analysis focused on statements expressing attitudes towards proactively addressing (potential) desires to die. Within the Delphi survey, 103 of 149 multi-professional participants (almost all of them with practical and only six with exclusively theoretical expertise in palliative care) generated 444 free text comments. Thereof, we identified three main categories related to dealing with desire to die: “outer framework“, “extended care system” and “health-professional-patient-relationship”. Ambivalences, taboos and uncertainties surrounding desire to die in palliative care became apparent. Experts are divided concerning the practice of proactively addressing desire to die. Even if these conversations–especially the proactive approach–are also viewed critically, we conclude that open-ended and respectful communication about desire to die between health professionals and patients can be understood as an eligible intervention in palliative care. Proactively addressing the topic is a possible way to open up such conversations.

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Section: Thematic Categoriesmentioning

confidence: 99%

“…However, §217 has been repealed in 2020 [13]. A recently published review investigated the discussion on termination of life on request in Europe during the last two decades [14]. The example of the Netherlands shows that legislation of termination of life on request goes hand in hand with an increase of cases administered.…”

Section: Introductionmentioning

confidence: 99%

“Withstanding ambivalence is of particular importance”—Controversies among experts on dealing with desire to die in palliative care

et al. 2021

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“…Freedom of choice also includes the personal right to choose death over life [ 1 ]. In the case of advance health care directives, the right to a nontreatment decision and the consensual withdrawal of potentially curative treatments are protected by regulating acts in most Western countries [ 2 ]. Furthermore, suicide is not considered a crime in such places [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

“…In the case of advance health care directives, the right to a nontreatment decision and the consensual withdrawal of potentially curative treatments are protected by regulating acts in most Western countries [ 2 ]. Furthermore, suicide is not considered a crime in such places [ 2 ]. However, there is an ongoing debate on the extent to which a second person should assist a person in willingly dying [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Trends and Patterns in the Public Awareness of Palliative Care, Euthanasia, and End-of-Life Decisions in 3 Central European Countries Using Big Data Analysis From Google: Retrospective Analysis

Huemer¹,

Jahn-Kuch²,

Hofmann³

et al. 2021

J Med Internet Res

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Background End-of-life decisions, specifically the provision of euthanasia and assisted suicide services, challenge traditional medical and ethical principles. Austria and Germany have decided to liberalize their laws restricting assisted suicide, thus reigniting the debate about a meaningful framework in which the practice should be embedded. Evidence of the relevance of assisted suicide and euthanasia for the general population in Germany and Austria is limited. Objective The aim of this study is to examine whether the public awareness documented by search activities in the most frequently used search engine, Google, on the topics of palliative care, euthanasia, and advance health care directives changed with the implementation of palliative care services and new governmental regulations concerning end-of-life decisions. Methods We searched for policies, laws, and regulations promulgated or amended in Austria, Germany, and Switzerland between 2004 and 2020 and extracted data on the search volume for each search term topic from Google Trends as a surrogate of public awareness and interest. Annual averages were analyzed using the Joinpoint Regression Program. Results Important policy changes yielded significant changes in search trends for the investigated topics. The enactment of laws regulating advance health care directives coincided with a significant drop in the volume of searches for the topic of euthanasia in all 3 countries (Austria: −24.48%, P=.02; Germany: −14.95%, P<.001; Switzerland: −11.75%, P=.049). Interest in palliative care increased with the availability of care services and the implementation of laws and policies to promote palliative care (Austria: 22.69%, P=.01; Germany: 14.39, P<.001; Switzerland: 17.59%, P<.001). The search trends for advance health care directives showed mixed results. While interest remained steady in Austria within the study period, it increased by 3.66% (P<.001) in Switzerland and decreased by 2.85% (P<.001) in Germany. Conclusions Our results demonstrate that legal measures securing patients’ autonomy at the end of life may lower the search activities for topics related to euthanasia and assisted suicide. Palliative care may be a meaningful way to raise awareness of the different options for end-of-life care and to guide patients in their decision-making process regarding the same.

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“…Bereits gezeigt wurde, dass in den Ländern mit dem Angebot zu Sterbehilfe bei psychischer Grunderkrankung eine Steigerung in der Inanspruchnahme während des untersuchten Zeitraums beobachtet werden konnte [8]. In einer rezenten Literaturübersichtsarbeit aus dem Jahr 2021 haben Calati et al Falls es zu einer Legalisierung der Sterbehilfe in Österreich kommen sollte, welche, wie in den Benelux-Ländern auch Menschen mit rein psychischen Erkrankungen umfasst, ist auf die unbedingte Notwendigkeit einer unabhängigen interdisziplinären Kommission hinzuweisen [2].…”

Section: Introductionunclassified

Angekündigter assistierter Suizid in der Schweiz – Ein Fallbericht

et al. 2021

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ZusammenfassungAktive Sterbehilfe ist aktuell in Österreich noch gesetzlich verboten. Aufgrund einer Entscheidung des Verfassungsgerichtshofs wäre assistierter Suizid ab dem Jahr 2022 gänzlich legal. Eine gesetzliche Regelung, die Grenzen zwischen legalen Formen einer Assistenz sowie deren Voraussetzungen und weiterhin unerlaubten Assistenzleistungen zieht, ist derzeit noch nicht in Sicht. Ein Suizid, der auf Verlangen des Suizidenten von fremder Hand herbeigeführt wird, bleibt jedenfalls weiterhin strafbar; dies auch dann, wenn der Suizident physisch nicht mehr in der Lage ist, bei seiner Tötung mitzuwirken. In mehreren europäischen Ländern wurde aktive Sterbehilfe bereits legalisiert und in manchen Ländern, wie zum Beispiel der Schweiz, kann assistierter Suizid auch ohne lebenszeitlimitierende Grunderkrankung, bei unerträglichem Leid und insuffizient vorhandenen weitere Behandlungsmöglichkeiten in Anspruch genommen werden. In diesem Fallbericht wird die Kasuistik einer Patientin geschildert welche, als Grunderkrankung an einer Persönlichkeitsstörung leidend, einen assistierten Suizid in der Schweiz geplant hatte. Es werden die ethischen und juristischen Hintergründe dieses Fallberichts diskutiert.Das zur Verfügung stellen assistierter Suizidmöglichkeiten birgt die große Gefahr, dass Menschen mit psychischer Erkrankung, insbesondere bei schweren depressiven Episoden, Behandlungsangebote ablehnen und anstelle Suizid durch einen professionellen Sterbehilfeanbieter wählen könnten. Insbesondere gewarnt werden muss vor der Tatsache, dass Menschen in aktuell schwer depressivem Zustandsbild aufgrund dessen zumeist unter eingeschränkter Entscheidungsfähigkeit leiden und nur bedingt über die Möglichkeit der freien Willensentscheidung verfügen.

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The ongoing discussion on termination of life on request. A review from a German/European perspective

Cited by 9 publications

References 55 publications

“Withstanding ambivalence is of particular importance”—Controversies among experts on dealing with desire to die in palliative care

“Withstanding ambivalence is of particular importance”—Controversies among experts on dealing with desire to die in palliative care

Trends and Patterns in the Public Awareness of Palliative Care, Euthanasia, and End-of-Life Decisions in 3 Central European Countries Using Big Data Analysis From Google: Retrospective Analysis

Angekündigter assistierter Suizid in der Schweiz – Ein Fallbericht

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