{"id":473,"date":"2010-06-25T14:42:10","date_gmt":"2010-06-25T13:42:10","guid":{"rendered":"https:\/\/blogs.bmj.com\/medical-ethics\/?p=473"},"modified":"2010-06-26T11:17:59","modified_gmt":"2010-06-26T10:17:59","slug":"german-court-rules-on-withdrawal-of-treatment","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/medical-ethics\/2010\/06\/25\/german-court-rules-on-withdrawal-of-treatment\/","title":{"rendered":"German Court Rules on Withdrawal of Treatment"},"content":{"rendered":"

German courts have today ruled that it is legal to withdraw lifesaving treatment with consent.\u00a0 According to Deutsche Welle<\/em><\/a>,<\/p>\n

Germany’s highest criminal court has ruled that passive assisted suicide is legal if the patient has explicitly decreed his or her wish that treatment used to keep the patient alive should be terminated.<\/p>\n

“Turning off a ventilator or cutting a feeding tube fall under the category of permissable\u00a0forms\u00a0of terminating\u00a0treatment,” judge Ruth Rissing van Saan said.<\/p><\/blockquote>\n

The DW<\/em> headline refers to this as confirming the legality of passive assisted suicide; the BBC, in its coverage, refers to it as having legalised euthanasia with consent<\/a>.\u00a0 As far as I can tell, both organisations are wrong.\u00a0 This, from the reports available at the moment, is not clearly euthanasia.\u00a0 At most, it’s about resolving a question concerning whether an advance directive refusing treatment should stand.\u00a0 Unless you think that withdrawing treatment at the request of the patient is de facto<\/em> euthanasia – and it isn’t –\u00a0then this is not euthanasia.<\/p>\n

Now, it is, of course, possible that the patient refuses a treatment so that<\/em> he or she can die.\u00a0 But for an action to be euthanasia, the intention of the person bringing about the end of life has to be to kill.\u00a0 An HCP who accedes to a refusal of treatment – either contemporaneously or by AD – does not thereby\u00a0necessarily intend to kill.\u00a0 It could be a matter of regret for the HCP in question that death will result; the HCP could coherently withdraw the treatment and hope for the patient’s miraculous survival –\u00a0and this would be enough to demonstrate that we aren’t dealing with euthanasia, since you can’t set out to kill someone and hope that they don’t die.\u00a0 The primary intention would be to accede to the refusal.<\/p>\n

(I’m not sure what the position is in German law, but it’d be untenable under English law to suppose that anyone who withdraws competently-refused life-preserving treatment is thereby committing euthanasia.\u00a0 Somewhat unfashionably, I’d even deny that they were killing – but I know I’m a rarity in thinking that there’s moral mileage in the killing\/ letting die distinction.)<\/p>\n

Pretty much the same seems to apply in respect of the “assisted suicide” interpretation: for sure, a patient may sometimes refuse treatment primarily as a means to die; but an HCP who accedes to the refusal has assisted a suicide in only the most etiolated sense – not in any morally meaningful way.<\/p>\n

Once again, there seems to be scope for all kinds of controversy to be generated thanks to infelicity, or carelessness, in the use of language.<\/p>\n

UPDATE: Udo Schucklenk comments here<\/a>.<\/p>\n

UPDATE 2: The more I think about it, the more puzzled I am about what passive assisted suicide might be. \u00a0Not intervening to prevent a suicide seems about the strongest I can come up with. \u00a0But it doesn’t seem like much…<\/p>\n","protected":false},"excerpt":{"rendered":"

German courts have today ruled that it is legal to withdraw lifesaving treatment with consent.\u00a0 According to Deutsche Welle, Germany’s highest criminal court has ruled that passive assisted suicide is legal if the patient has explicitly decreed his or her wish that treatment used to keep the patient alive should be terminated. “Turning off a […]<\/p>\n

Read More…<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[511,563,591],"tags":[],"class_list":["post-473","post","type-post","status-publish","format-standard","hentry","category-in-the-news","category-language","category-life-and-death"],"yoast_head":"\nGerman Court Rules on Withdrawal of Treatment - Journal of Medical Ethics blog<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/medical-ethics\/2010\/06\/25\/german-court-rules-on-withdrawal-of-treatment\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"German Court Rules on Withdrawal of Treatment - Journal of Medical Ethics blog\" \/>\n<meta property=\"og:description\" content=\"German courts have today ruled that it is legal to withdraw lifesaving treatment with consent.\u00a0 According to Deutsche Welle, Germany’s highest criminal court has ruled that passive assisted suicide is legal if the patient has explicitly decreed his or her wish that treatment used to keep the patient alive should be terminated. “Turning off a [...]Read More...\" \/>\n<meta property=\"og:url\" content=\"https:\/\/blogs.bmj.com\/medical-ethics\/2010\/06\/25\/german-court-rules-on-withdrawal-of-treatment\/\" \/>\n<meta property=\"og:site_name\" content=\"Journal of Medical Ethics blog\" \/>\n<meta property=\"article:published_time\" content=\"2010-06-25T13:42:10+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2010-06-26T10:17:59+00:00\" \/>\n<meta name=\"author\" content=\"BMJ\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"BMJ\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"2 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/2010\\\/06\\\/25\\\/german-court-rules-on-withdrawal-of-treatment\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/2010\\\/06\\\/25\\\/german-court-rules-on-withdrawal-of-treatment\\\/\"},\"author\":{\"name\":\"BMJ\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/#\\\/schema\\\/person\\\/ba3da426ed20e8f1d933ca367d8216fe\"},\"headline\":\"German Court Rules on Withdrawal of Treatment\",\"datePublished\":\"2010-06-25T13:42:10+00:00\",\"dateModified\":\"2010-06-26T10:17:59+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/2010\\\/06\\\/25\\\/german-court-rules-on-withdrawal-of-treatment\\\/\"},\"wordCount\":503,\"commentCount\":6,\"publisher\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/#organization\"},\"articleSection\":[\"In the News\",\"language\",\"Life and Death\"],\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"CommentAction\",\"name\":\"Comment\",\"target\":[\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/2010\\\/06\\\/25\\\/german-court-rules-on-withdrawal-of-treatment\\\/#respond\"]}]},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/2010\\\/06\\\/25\\\/german-court-rules-on-withdrawal-of-treatment\\\/\",\"url\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/2010\\\/06\\\/25\\\/german-court-rules-on-withdrawal-of-treatment\\\/\",\"name\":\"German Court Rules on Withdrawal of Treatment - 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