Saturday, June 26, 2010

German court makes the wrong decision by approving death by dehydration.

Germany's federal court of justice overturned a conviction yesterday against a lawyer who advised his client to remove the feeding tube of her 72-year-old mother in 2002.

This decision is wrong because the court wrongly defined fluids and food as medical treatment, rather than basic care.

The court approved the direct and intentional dehydration of people who are not otherwise dying. This case was of a person who could not have consented to dying by dehydration, meaning this would be considered a death without explicit request or consent. This decision opens the door to dependent and incompetent people being killed by dehydration, a death that lacks dignity and compassion.

Terri Schiavo died by dehydration in March 2005.

The Irish Times reported:
Five years earlier, shortly before Erika Küllmer suffered a brain haemorrhage and lost consciousness, her daughter Elke Gloor said she had insisted she did not want to be kept alive artificially.

After consulting her lawyer, and with her own brother present, Ms Gloor cut the cable with a scissors only to have care facility staff reconnect it. Ms Küllmer died shortly after of natural causes.

The state prosecutor pressed charges against her daughter and the lawyer, Wolfgang Putz. Charges against Ms Gloor were dropped because the court ruled she had followed “mistaken” legal advice, while Mr Putz was given a nine-month suspended sentence for attempted manslaughter.

The federal court yesterday upheld the lawyer’s appeal against his conviction.

In its ruling, the court argued that cutting the feeding tube made possible a “natural” death because it ended treatment that was being carried out against the patient’s will.

“A person’s free will must be respected, in all stages of life,” the judges ruled, insisting that “death on demand” remained a crime.

Germany’s federal justice minister welcomed the verdict.

“The ruling gives legal clarity on a fundamental question in the conflict over assisted suicide, namely what is permissible in the passive sense and prohibited in the active sense,” said Sabine Leutheusser-Schnarrenberger, the federal justice minister. “This is about a person’s right to decide, and hence touches upon a key question of how to live with dignity.”

Hospice groups spoke of a “black day” for patients’ rights while the German doctor’s union warned of “arbitrariness” in future medical treatment.

The case made headlines in 2002 after Mr Putz reached agreement with Ms Küllmer’s care facility to remove feeding tubes, only for the facility staff to change their mind at the last minute.

After her daughter cut through the feeding tube, Ms Küllmer was removed to a clinic but died two weeks later. Four months later, her son took his own life.

Yesterday’s ruling legalises active measures as well as passive measures to help end a person’s life if it is their wish. It is intended to work alongside a law introduced last year allowing people to make a written declarations for or against treatment to prolong their lives. The German doctors’ union remains concerned that this contradicts their Hippocratic oath to patient care.

Germany’s hospice association criticised the ruling yesterday, saying it opened the door to abuse by not clarifying what was active and what was passive assistance in suicide. It pointed out that Ms Küllmer’s wish not to be kept on life support was given verbally to her daughter and not in written form.

Assisted suicide is particularly controversial in Germany because of memories of the forced euthanasia programme in the Nazi era.

Yesterday a former Hamburg politician was acquitted of manslaughter after aiding an elderly woman to kill herself in 2008 because she didn’t want to move into a home.
To withdraw hydration from a person who is not otherwise dying is ethically a form of euthanasia because the direct and intentional cause of death is dehydration and not a natural death. The distinction is clear, that when a person is dying and nearing death, it is proper care to provide hydration and nutrition until the person cannot physiologically benefit from it. It is important that the care givers not provide too much hydration and nutrition, but to continue providing what the person requires.

Did Hans and Sophie Scholl, who were executed for their leadership of the White Rose Resistance, die in vain? The first method of euthanasia in the German hospitals was euthanasia by dehydation. Then the German doctors perfected the method of killing people with disabilities and others who were determined to be "useless eaters" by gas. Once the technique of killing with gas was perfected by killing people with disabilities, the method was then moved to the death camps. History appears to be repeating itself

The court should have upheld the conviction and stated that medical treatment, is always optional, but food and fluid, even when medically assisted, do not represent a medical treatment but rather a form of basic care. Basic care must be treated as necessary so long as it is needed.

Link to the article in the Irish Times: http://www.irishtimes.com/newspaper/world/2010/0626/1224273365911.html

Link to the article in Reuters: http://www.reuters.com/article/idUSTRE65O2MD20100625

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