On September, 1st, a new legislation became effective: the Third Amendment of the Medical Assistance Law. Now, patient’s decrees will only be valid if made in the form of writing and signed by the author himself through writing his name or putting a notarized symbol underneath.

Everything is supposed to get easier – where it actually gets more complicated. The new law is supposed to give you more autonomy by permitting you to decide which sort of death you want to die when the time comes. You can now commit other people to act according to your last wish.

The magic word is: “Patient’s Decree“.

As all legislation, the law is neither clear nor simple. In order to solve this problem, brochures helping how to apply the law can be obtained. They contain pre-formulated forms and text elements for the various death scenarios. What is even more practical: you can download them.
Simple “use cases” help when it comes to writing your decree. By simply putting a cross at the right place or combining individual elements, you can decree what you want to happen. For example, you can pre-arrange what treatment you wish in case of your falling into a coma or suffering from an incurable disease. Your individual death is treated like a common business process.

Numerous advice is given:

When writing a patient’s decree, you should not come up with your own text. Instead, you had better adhere to the pre-arranged elements and forms. Due to the difficult legal situation, writing your own text without a professional consultant might easily make the entire decree invalid.

Besides, you should also seek the help of a competent advisor, perhaps the family doctor or the pastor. They might also be a good choice of trustee if you have no children or family of your own.

Not to mention that you should revise your patient’s decree every other year. Your individual experiences during that time will have made the regulations written down in your decree obsolete after that time.

These are all things I can understand. After all, if I had written a patient’s decree when I was 20, I certainly would by now have forgotten what I wrote at the time. Besides, when I was 20, the idea that life after 40 might still be worth living was strange to me. And I consider it preposterous to assume that I might now know what will be my wishes at the time of death.

But I regret that I am supposed to define my death like a process. Maybe the next thing is that I will have to follow an ISO norm when doing it.

All I want is for those people and doctors who will (hopefully) accompany me on my last way to conduct life-preserving procedures only after an ethically responsible weighing of values. What I want to prevent by all means is that their decisions be motivated by economical interests.

Dying is perhaps the last event we experience. And death should be something sacred that must not be simplified and become a “use case“. I am afraid all these well-meant laws will (again) be pointless.

(Translated by EG)

The brochures can be downloaded from the internet, but you can also buy them in a bookshop (I think they cost 3.90 Euros).
;-)Now I wonder what receipt number the family doctor will have to enter on the health insurance form in order to charge “patient’s decree counselling over a time-span of two years” and how much money our “Health Fond” will provide for this additional medical care.

3 Kommentare zu “Patient’s Decree: “A New Law!” or “Will Dying Become a Process?””

  1. Chris Wood (Tuesday October 13th, 2009)

    What does “use case” mean?

  2. rd (Tuesday October 13th, 2009)

    Anwendungsfall, Fallbeispiel, siehe auch


    Einfach die denkbaren Szenarien die auf dem Wege zum Erreichen eines Zieles möglich sind. Im konkreten Fall die Varianten auf dem Wege zum Tod, bei denen es möglich ist, durch Technik das Sterben hinauszuschieben.

    Vielleicht als Beispiel zum Artikel: Ein “use case” könnte das Szenario sein, wenn der Autor der Patientenverfügung ins Koma fällt. Da kann es verschiedene Ursachen geben, wie Herzinfarkt, Gehirnschlag, eine andere Krankheit oder ein Unfall. Außerdem gibt es verschiedene Arten von Komas, wie z.B. das Wachkoma. Das wären dann die sub-“use case”. Jetzt gilt es zu definieren, wie die Szenarios behandelt werden soll, welche medizinischen Maßnahmen gewünscht und abgelehnt werden sollen usw.

    ;-( Das ganze könnte man auch in UML definieren, dann wäre die Patientenverfügung aber wahrscheinlich rechtlich nicht wirksam?!

  3. oli (Tuesday October 20th, 2009)

    Die Gefahr, dass so eine Verfuegung ungueltig ist, ist nicht zu unterschaetzen. Ein Richter prueft, ob die Verfuegung alles notwendige enthaelt (alle Faelle abdeckt). Ist dies nicht der Fall, wird zur Entscheidung dieser Faelle ein Betreuer eingesetzt. Dies kann ein Verwandter sein, kann aber auch ein “Berufsbetreuer” sein. Das entscheidet der Richter ganz alleine, wer das wird.

    Wenn Du kein Vertrauen in einen Berufsbetreuer hast (oder diesen nicht zahlen willst ;)), solltest Du halt besser eine wirksame Verfuegung haben. Wenn der Richter das leicht feststellen kann (Formblatt mit allen rechtlich richtig beschriebenen Formulierungen), steigt die Wahrscheinlichkeit der Wirksamkeit enorm.

    Btw, meine Frau ist zur Zeit Richterin am Versorgungsgericht und macht unter anderem genau das, Betreuer einsetzen etc.

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