Huntington's disease and the law.

Huntington's disease (HD) is a relentlessly progressive and fatal neurological condition that is inherited. It has serious and disabling physical and mental components. As such, it impacts upon those who have HD, those with the potential to inherit it, and those who care for those with HD in a wide variety of ways. These can have many legal ramifications including in relation to evolving impairments of capacity which can have an outcome in terms of involuntary status as mental health patients, testamentary capacity and the need for guardianship and administration. It can have effects upon fitness for parenting, obligations for spousal maintenance, and the quantum of compensation from a tortious incident to which a person is entitled. It has repercussions for criminal liability and culpability. This article reviews case law from a number of countries in relation to such matters, noting the broader radiation to others of the effects of HD, and reflecting on the need for legal and medical professionals to be aware of the legal consequences of HD for them to be able to discharge their responsibilities holistically, sensitively and informedly.

[What to do in case of disagreement between physician and patient: a few legal and ethical considerations]. / Que faire en cas de désaccord entre le médecin et te patient: quelques balises juridiques et éthiques.

A patient may not demand an intervention that is not medically indicated. Such situations put the physician in a conflictual position that may jeopardize the physician-patient relationship. Exploring the different viewpoints may help explaining the sources of disagreement and reach a consensus. When this fails, the final decision in Switzerland belongs to the physician, including in case of an incompetent patient. A project of a revision of the Swiss civil code would confer decision-making responsibilities in such cases to the person closest to the incompetent patient. This is cause for concern given the poor ability of surrogates to accurately predict patient preferences and the additional emotional burden to surrogates. Early discussion with a competent patient and establishment of advance directives is therefore extremely important.

[Dying with dignity-between autonomy and care. A contribution to the current legal discussion in Germany]. / Sterben in Würde-zwischen Autonomie und FürsorgeEin Beitrag zur aktuellen juristischen Diskussion.

The juridical discussion about "dying with dignity" in Germany is concentrated on the aspect of autonomy of the patients and the juridical instruments of "power of attorney". The aspects of care for dying patients and a multidimensional concept of dignity are in danger of being neglected. In the context of the discussion of rationing in the health sector the accentuation of the aspect of autonomy could support the development of new acceptance of euthanasia and the stoping of treatment. In this essay the current discussion in Germany will be shown with consideration of current legal decisions.