How does life support help

Compensation for life-extending measures?

The patient and testator, born in 1929, was under the care of a lawyer until his death, which also included health care and personal care. Since 2006 the patient has lived in a nursing home. During an inpatient stay in hospital in September 2006, a feeding tube was placed on him, through which he was artificially fed until his death. The defendant, the attending physician, had been looking after the patient as a general practitioner since spring 2007. The patient had not drawn up a living will. His will could not be determined in any other way with regard to the use of life-sustaining measures. In the period 2010 to 2011, the patient had to go through serious health crises on a regular basis. In view of his general health, intensive medical treatment as part of an inpatient hospital stay was dispensed with from 2011 onwards. In October 2011 the patient died in the hospital.
The plaintiff claims that tube feeding has not been medically indicated since the beginning of 2010 at the latest, nor has it been justified by an ascertainable patient's will. Rather, it led exclusively to a senseless prolongation of the patient's illness-related suffering with no prospect of improvement in the patient's state of health. The defendant, as the treating family doctor, was therefore obliged to align the therapy goal with palliative death and to stop tube feeding. This caused serious injuries to the patient's body and personality. Since the plaintiff was the sole heir of the patient and testator, he would now be entitled to compensation for pain and suffering and to reimbursement of unnecessary treatment and care expenses.

In the first instance, the responsible regional court had dismissed the complaint. In response to the plaintiff's appeal, the higher regional court had awarded compensation for pain and suffering in the amount of 40,000 euros, but otherwise dismissed the complaint. In its decision mentioned above, the Federal Court of Justice emphasized that human life, as the highest-ranking legal asset, is fundamentally and absolutely worthy of preservation. No third party would be entitled to judge the value of human life. That is why it is forbidden to view life and thus also a continued existence suffering from suffering as damage in the legal sense. A right to payment of compensation for pain and suffering cannot therefore be derived from the patient's continued existence made possible by life-sustaining measures.
However, the Federal Court of Justice has also made a fine-grained distinction by stating that the increasing dependence of the dying process on medical options has long since made death appear no longer just a fateful event, but rather the result of a decision made by humans. From the constitutionally secured requirement to understand people not as an object, but as a subject of medical treatment, it follows that the patient has the right in every phase of life, including at the end of life, to decide for himself whether or not he wants to seek medical help Not. After that, even after the incapacity to give consent - e.g. B. in the case of a coma patient - the actually expressed or presumed will of the patient is decisive for the decision on whether or not to undertake medical measures. If the will is to refrain from life-sustaining measures and thus to make death possible, a defense claim against life-prolonging measures follows. The state's duty to protect life under Article 2 of the Basic Law then takes a back seat to the patient's right to self-determination, even if there would have been a healing or life perspective without the termination of treatment. In this respect, the Federal Court of Justice has emphatically emphasized the patient's right to self-determination.

Against this background, it is astonishing when the Federal Court of Justice then withdraws to a legally formal point of view, namely to the purely legal argument that, as shown above, a life-prolonging measure can under no circumstances be damage in the civil law sense. Even if the patient himself may regard his life as unworthy of life, the constitutional order prohibits all state power, including case law, from making such a judgment on the life of the patient concerned with the conclusion that this life is harmful. Regardless of this, human knowledge eludes whether a life full of suffering can be a disadvantage compared to death. This decision of the Federal Court of Justice is already discussed very controversially in the legal literature but also in the general social area. However, it is generally felt as positive that the Federal Court of Justice has emphatically confirmed the patient's right to self-determination and also emphasized that a person can in principle decide for himself or herself about his or her life and its termination, regardless of whether third parties consider this person's considerations to be convincing or not.

It is all the more important to put down your personal values ​​in a living will so as not to get into a situation where your own life lasts longer than personally desired. This can also be associated with pain sensations that are not desired. The Federal Court of Justice has ruled that life-prolonging medical measures cannot lead to a claim for damages. We hope that this decision will not unnecessarily reaffirm medical treatment staff in the future in the assumption that they will take and continue life-prolonging measures in case of doubt, although there are sufficient indications that these cannot be brought into line with the wishes of the patient being treated. If unjustified life-prolonging measures are taken, it is up to the relatives in particular to seek legal help in order to end such violations of the patient's right to self-determination with legal help, if necessary.