Living Wills Under Debate

In a three-hour parliamentary debate that was often emotionally charged, lawmakers discussed their options for putting living wills, or advance directives, on a legal footing in future sessions.

Living wills are meant to help seriously ill people die in a manner they themselves would prefer. They can state whether they would prefer to die at home rather than in an intensive care unit in hospital. And they can choose whether or not they want aggressive life-prolonging measures, like being placed on a ventilator, hooked up to a feeding tube, being resuscitated if their breathing or heartbeat stops.

The documents are written when people are still in full control of their faculties and are designed to guarantee that their wishes are fully respected when the authors can no longer speak for themselves.

Legal uncertainty

Writing such directives has been common practice in Germany for a long time, but as Social Democratic lawmaker Joachim Stünker pointed out, following a recent court ruling, much legal uncertainty remains as to how binding such directives are for relatives and medical personnel.

"We're debating this issue, because 7 to 8 million Germans have written such a document and trust that their wishes will be respected and carried out," Stünker said. "In doing so, they've declared their total opposition to being forced to accept what's possible medically, when this means prolonging a life which they feel is no longer worth living."

Christian Democratic parliamentarian Wolfgang Bosbach agreed that modern medicine has triggered many ethical questions that need to be dealt with.

Prolonging pain?

"The new and seemingly boundless capabilities of modern medicine cannot only prolong life. They can also prolong pain and the process of dying," he said.

The more impressive medical achievements become, the more we perceive death no longer as an act of fate, but a result of human decision-making, he added.

Bosbach said he believed people's wishes as laid down in a written declaration should only be accepted unconditionally if the patients concerned are already fatally ill.

But Justice Minister Brigitte Zypries said people's right to self-determination doesn't allow for a difference to be made between the terminally ill and those with a chance of survival.

Not a euthanasia debate

"People are afraid that they may no longer be able to die in peace when they grow old," she said. "They want to have a legal choice to say that they're not willing to be kept alive artificially against their will. In their eyes, the boon of modern medicine can easily turn into a bane."

Opposition Liberal Democratic lawmaker Michael Kauch argued that the current debate must not be mixed up with attempts to legalize euthanasia through the back door:

'Letting nature take its course'

"We're not talking about killing people," he said. "It's about letting people die as God has planned. Let nature take its course, if patients so wish -- that's what it's all about."

The Bundestag debate is meant to be a first broad discussion about end-of-life regulations in Germany. No decisions have yet been made. Later this year, parliament will debate the issue again. But a vote on draft legislation to be prepared by Germany's ruling coalition is not expected before 2008.