Citation

Sahm S. Zeitschrift fur Medizinische Ethik 2019; 65(3): 211-226.

Copyright

(Copyright © 2019)

DOI

10.14623/zfme.2019.3.211-226

PMID

unavailable

Abstract

After introduction of the law that prohibits business like assistance with suicide a debate about voluntary refusal of nutrition and fluids (VRNF) has been prompted. Problems had been identified to separate VRNF from acts such as suicide and assistance with suicide. The majority of cases of VRNF are related to the presence of severe disease at the end of life. Under these circumstances VRNF is held as normatively equivalent to rejection of medical interventions which is ethically unobjectionable. VRNF without presence of any disease may be distinguished from suicide by distinctive features of the act. Yet, conflicts may arise for nurses and physicians due to the prominent suicidal intention associated with the act within this context. If there is a pre-existing relationship of care the persons must not be abandoned. Rather, the obligation to alleviate suffering remains unchanged. To care and to ease suffering is not to be held as participation in the act. This is the case provided no incentives for VRNF are given and care is embedded in a life-affirming culture of palliation. © Zeitschrift für medizinische Ethik, Basel.All rights reserved.

Language: de

Keywords

suicide; assistedsuicide; obligationtomedicate; palliative culture in medicine; Voluntary refusal of nutrition and fluids