On the occasion of a legal dispute between the relatives of a woman who had lost the ability to express her will independently due to a stroke and epileptic seizures and whose advance directive stipulated that no more “life-extending measures” should be carried out in a corresponding condition, the German Federal Court of Justice (Bundesgerichtshof, BGH) issued a decision in 2016 which led to a far-reaching revision of the legal handling of advance directives. According to the decision, the wording in question is not sufficiently precise to justify a legally effective requirement regarding the possible discontinuation of a feeding tube. The judges therefore demand greater precision in the content of advance directives.

The legal dispute had been transferred from the Local Court of Adelsheim via the Regional Court of Mosbach to the Federal Court of Justice (BGH), as two daughters of the patient had interpreted their mother’s advance directive differently. While one of the daughters did not agree that the advance directive covered the decision to dispense with a feeding tube, the other daughter took the opposite view.

The order of the BGH states:

“The written statement that ‚no life-extending measures’ are desired does not in itself contain the concrete treatment decision of the person concerned, which is required for a binding advance directive. However, the necessary specification can be achieved by designating certain medical measures or by referring to a sufficiently specified disease or treatment situation.”