Citation

Erbguth FJ, Erbguth L. Aktuelle Neurol. 2016; 43(2): 102-112.

Copyright

(Copyright © 2016, Georg Thieme Verlag)

DOI

10.1055/s-0042-100902

PMID

unavailable

Abstract

End-of-life decisions in neurology have repeatedly given occasion for controversies. Often these are based on lack of knowledge of the juridical and ethical framework conditions. This review describes the juridical-ethical basis for the implementation and continuation, and for withholding and withdrawal of life-sustaining measures, in particular, the significance of medical indication and patient's will. The different forms of assisted dying (Sterbehilfe), namely homicide by request, assisted suicide, palliative symptom relief and treatment withdrawal are characterized. The Principles of the German Medical Association in end-of-life situations are illustrated. Specific features of neurological treatment scenarios are discussed such as the preclinical and clinical emergency and acute situation, the decompensation of stable chronic severe brain injury situations, and chronically progressive neurodegenerative diseases. In the latter situations, an early Advance Care Planning could contribute to improved end-of-life decision-making. © Georg Thieme Verlag KG Stuttgart, New York.

Language: de

Keywords

human; homicide; decision making; palliative care; assisted suicide; injury severity; emergency care; neurology; degenerative disease; terminal care; treatment withdrawal; brain injury; Article; ethical decision making; end of life; assisted dying