[Preparation and execution of advance directives and enduring powers of attorney]. / Erstellung und Realisierung von Patientenverfügung und Vorsorgevollmacht.

If a person wants to preclude other people making decisions on his/her behalf, this needs to be recorded in a legally relevant form by means of a declaration of intent. For example, the latter could be a contract (nursing home contract) or an advance directive. The circumstances under which a declaration becomes effective have to be exactly and carefully worded. Also, it has to be accurately defined who is to enforce the declaration of intent against defiance and in which situation. Physicians, lawyers, nursing staff, politicians, members of ethics committees, sponsors, relatives--everyone may have a different opinion, and the patient's well-being might easily be ignored. A legal regulation will contribute little to safety at the end of life. The responsibility lies with the physician. The legislator cannot guide the physician's therapeutic decisions, but an invalid patient can who has expressed his desire to die and unmistakably advised his physician on when to refrain from which procedures.