Legal regulations at the end of life: where is government intervention needed?
For people at the end of life, it is often difficult to decide on their own how much medical care they should be given. To what extent should medical decisions fall to third parties (family members, physicians, hospices, nursing home directors, health insurance companies)? How much government control is needed?
Project description (completed research project)
Persons who - together with dying persons or in their place - must make decisions on life-sustaining treatments or measures hastening death carry a great deal of responsibility. At present, the law does not lessen their burden of responsibility, as there are no clear decision criteria. At the same time, the persons involved in the decision-making process at the end of life are influenced by various factors (for example, cost incentives). This situation can result in decisions and actions that are not always for the good of the dying person.
To ensure that decisions at the end of life are in the interest of the persons concerned, appropriate legal regulations are indispensable. The establishment of the living will and the prevailing criminal law provisions do not suffice. For instance, the issue arises as to whether regulations are needed to guarantee the independence and the personal and specialist qualifications of personnel providing assistance to die. In addition, there is the question as to whether the law should more precisely define what resources and infrastructures for life support measures must be made available. And, not least, it should be discussed whether and how decisions at the end of life and their implementation should be monitored.
From a legal perspective, the study will show how human rights to life and integrity, self-determination and dignity can be realised in an area where autonomous decision-making is often no longer possible and the persons concerned need special protection. The goal is to develop, for the benefit of policy and society, a practicable regulatory model for assisted dying in medical and social institutions. With this, the study will contribute towards protection of seriously ill and elderly persons and, in the interest of the actors involved, establish legal certainty.
Regulating end-of-life decisions in clinics, nursing homes and hospices: Human rights standards and administrative law instruments