Judging from the reactions of the German press, most people in Germany – like most Americans – were repulsed by the grandstanding of Bush Republicans as they exploited a family tragedy for political advantage. But the Schiavo affair has led to a great deal of discussion and soul-searching in Germany – as it has in the US – about patients’ rights and the end of life. Could the same thing happen in Germany? What rights does a patient have? Who determines what care a comatose patient should receive? From what I’ve been able to read, there are no clear answers.
Stern asks: Would Terri Schiavo starve to death in Germany? The answer is: most likely no. If a written living will(Patientenverfuegung) is not available, the family or spouse may not impose "presumed wishes" from a comatose patient, nor would it be legal for a doctor to remove a feeding tube or other life support means.
Die Essener Anwältin Beate Linke, im Deutschen Anwaltverein für
Patientenrecht zuständig, sagt: "Wenn keine Patientenverfügung zum
Abbruch der Versorgung vorliegt, hätte ein Arzt keine Chance, Maßnahmen
zu ergreifen. Die lebenserhaltenden Maßnahmen müssten fortgesetzt
werden." Der Chef des Klinikärzteverbands Marburger Bund, Ulrich
Montgomery, sagte, es sei unvorstellbar, dass man hier eine
Wachkoma-Patientin durch Entzug der Magensonde verhungern lasse.
But taz has an interview with Steffan Thoms , a lawyer in Munich who specializes in medical matters. Thoms comes to a very different conclusion: the courts may recognize the "presumed wishes" of the patient, even when a living will is not available:
Steffen Thoms: Das Vormundschaftsgericht
würde das Entfernen der Magensonde erlauben, wenn dies dem geäußerten
oder mutmaßlichen Willen der Frau entspricht, die Ärzte keine Hoffnung
auf Besserung mehr haben und der rechtliche Betreuer der Patientin dies
beantragt. (…)Was gilt, wenn eine solche Patientenverfügung fehlt?
Dann kommt es auf ihren mutmaßlichen Willen an. Da müssen
Verwandte und Freunde befragt werden, ob die Patienten sich früher mal,
zum Beispiel anlässlich einer Fernsehsendung, darüber geäußert hat, wie
sie im Koma behandelt werden will.
So the situation is just as murky in Germany as in the US. The Federal Justice (Bundesjustizministerin) Brigitte Zypries has introduced legislation that would make the wishes of the patient binding if they are set forth in a living will . The bill would permit "passive" assisted dying in cases like Schiavo’s; "active" assistance – as is practiceed in The Netherlands – would remain illegal. It is not clear the chances or ratification this legislation has in the Bundestag.
In the meantime, it is perhaps best – as erphschwester recommends – to have someone on your side who would transport you to Holland in order to avoid the tragic farce such as we have witnessed this past weekend.
