[Selected legal aspects of end-of-life care : Euthanasia, palliative sedation and emergency medicine]. / Ausgewählte juristische Aspekte der Medizin am Lebensende : Sterbehilfe, palliative Sedierung und Notfälle.

The law distinguishes between several forms of intentional participation in life-shortening or life-ending acts ("euthanasia"). Therapy limitation is permitted or even required if the prerequisites for a medical intervention are no longer present. In contrast, active-direct killing (upon request) is categorically prohibited (§ 216 "Strafgesetzbuch" [StGB]). Considering the "fundamental right to self-determined dying", however, there is now a clear tendency to narrow the scope of punishable offences. This liberal "spirit of time" has already prevailed for assisted suicide, provided that it is carried out in a "freely responsible" manner. For pain therapy to reduce suffering, risks may be taken in light of the protection of life; however, here too, legitimization is required through the principle of actual or at least presumed consent. There are challenges in assessing and executing the patient's will in (suicidal) emergency situations, especially the adherence to autonomously made decisions on death.

[Selected legal aspects regarding limiting treatment at the end of life : Patient advance directive, proxy and indications]. / Ausgewählte juristische Aspekte der Therapiebegrenzung : Patientenverfügung, Stellvertretung und Indikation.

Respect for the patient's right to self-determination and the professional medical assessment of the (continued) existence of a therapeutic prospect of success of the respective curative intervention ("indication") are the two central reference parameters of every medical therapeutic decision. This is particularly true in cases of a progressive, irreversible, fatal course of the disease. However, the assessment of the presumed will of the patient or the meaningfulness of curative (intensive care) prolongation of life frequently causes difficulties. The law cannot eliminate these doubts in each individual case; it does, however, provide a framework so that factually and ethically justified therapy decisions can be made in each case. In this function, this legal framework-no matter how much it must first be concretized in the respective decision case-demands strict observance. This also includes the most recent change in the law that went into effect on 1 January 2023, through the introduction of a statutory right of (emergency) representation for spouses.