Self-determination at the end of life
Medical decisions at the end of life are closely connected with the dogma of patient self-determination. This dogma will be critically examined from a legal standpoint, with the research being guided by the concrete needs of dying patients and the experiences of medical health care personnel.
Project description (completed research project)
The importance of self-determination in connection with medical treatment has increased over the last decades. The patient’s living will, for example, allows persons to make their own end-of-life decisions even when they are no longer competent and able to give informed consent. This study starts out from the assumption that the legal basis does not in all aspects do justice to medical practice and the reality of dying patients and that it therefore should be reexamined. This should not be confined to looking at how the problem of self-determination has been handled up to now. Instead, the task is to work out solutions for the legal basis of end-of-life medical decisions that are in accord with the medical and psychological realities. Based on that, the project will make specific proposals for regulations by the lawmakers and draft guidelines for medical health care personnel with no legal training.
This study works with recognised methods in the field of law; to compare different draft legislation, findings and experience of other legal systems will be utilised. For a better assessment of what practical needs the regulation must cover, the project will study empirically what problems confront medical personnel in clinics and care facilities for the seriously ill.
The results of this study will be important for lawmakers, the authorities and the courts, since decisions on the end of life are being made increasingly at the legal level and through legal means. But also the medical profession and further health care personnel need clear regulations. They all need to know whether a decision is not only appropriate from a social or medical perspective but also has a sound legal basis.
Self-determination at the end of life in the Swiss legal framework: a critical analysis of the legal duty of having to decide for oneself