German Medical Association: Principles regarding the accompaniment of the dying process by physicians

In February 2011 the German Medical Association published its revised principles regarding the accompaniment of the dying process. According to the German Medical Association's own statement this revision was necessary for two reasons: first, because of a revised version of the law relating to care and control and secondly, because of a change in attitude by the physicians, according to a poll of 2009.

Besides many other passages of the original document, the new version also includes the programmatic set phrase of the preamble of 2004: “It is the duty of the physician to protect and restore the patient's health as well as to alleviate the patient's suffering and assist dying patients until death, while preserving life according to the patient's right of self-determination.” Both preambles indicate that life cannot be preserved under any circumstance and that the physician's duty to do so is limited. Furthermore, the rejection of “active euthanasia” (2004) as well as “killing of the patient” remains intact.
Yet, the formulation regarding assisted suicide has changed. While the 2004 version states that “The physicians' involvement in suicide contradicts medical ethics and can be punishable”, the 2011 version states that “The physicians´ involvement in suicide is not a medical task.” It then becomes quite clear that assisted suicide should not belong in the medical field of activity (of the physician). Nevertheless, the new formulation of the 2011 version has changed the tenor of the debate on which the president of the German Medical Association, Jörg-Dietrich Hoppe, dwells in his foreword: “This explicit statement underlines the fundamental principles regarding accompaniment of the dying process by physicians. It substitutes the former statement which pointed out that the physicians' involvement in suicide of the patient contradicts medical ethics. Thus it recognizes the many different and individual concepts of morality of the physicians in a pluralistic society, without questioning the fundamental principles and statements regarding the accompaniment of the dying process by physicians.”

Bundesärztekammer (2011): Grundsätze der Bundesärztekammer zur ärztlichen Sterbebegleitung. In: Deutsches Ärzteblatt 108 (7) (18.02.2011), Seite A346 - A348. Online Version (German)

Bundesärztekammer (2004): Grundsätze der Bundesärztekammer zur ärztlichen Sterbebegleitung. In: Deutsches Ärzteblatt 101 (19) (07.05.2004), Seite A1298 - A1299. Online Version (German)

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