At the end of life

In a joint statement released on January 26 the German Bishops’ Conference (DBK) and the Council of the German Evangelical Church (EKD) announced the new Christian Advance Directive for Healthcare. The document was jointly drawn up by DBK and EKD in conjunction with Germany’s Community of Christian Churches (ACK). It marks an important step in terms of hot ethical issues and life termination questions and as relates to relationship between Christian Churches and the progress of ecumenism. A Christian approach. With the document titled “Christian Advance Directive, proxy, treatment and healthcare choice instructions by the patient”, with annexed living will form, the DBK, the EKD, and all Christian Churches that are ACK members intend to provide a guideline to address life’s termination and terminal diseases in compliance with the will of the patient. The statement takes into account ethical and theological aspects for a Christian approach to the end of life on earth, presenting at the same time the most significant juridical standpoint on the various options. The version presented a few days ago in Cologne is an expanded and updated version of the Christian living will drawn up in 1999, and amended in 2003. Along with information and healthcare proxy forms, the document provides for patients’ treatment choice instructions, along with directions for health care representatives. To the light of ethical questions stemming from scientific progress and considering the risk of therapeutic obstinacy the DBK informative page (www.dbk.de/themen/christliche-patientenvorsorge), recommends “to consider with caution whether each procedure is compatible with Christian ethics”, as in single cases “the decision must result from the concrete situation of the dying person, from his needs, and it must be taken in harmony with his desires and thought”. The Christian reference to the document “doesn’t mean that it could be used by Christians only, rather that it is based on Christian convictions, such as the nonacceptance of euthanasia or of medically-assisted euthanasia”. Providing an answer. During the presentation, Msgr. Robert Zollitsch, DBK president said, “it is appropriate and ethically responsible” to provide advance instructions on the end of life”. “Many people have special expectations from the Churches”, he said. “Indeed, they look forward to the Churches’ specific guidelines and answers to life termination issues, and justly so. Thanks to our charitable services we have ample experience in this field. This is why many people, especially as relates to life termination, feel secure with the Church”. Zollitsch equally underlined the terms of personal responsibility with the living will: “Self-determination does not occur regardless of one’s physical self nor regardless of one’s human and social relations. Self-determination, thus self-responsibility, is the responsibility which third parties – including the public realm – can assume regarding patients. The Christian advance statement is designed to provide the possibility of applying one’s religious beliefs to life termination”. However, he remarked, “the role of those accompanying terminal patients to the end of their existence, thus giving an important contribution to a dignified death, is equally important”. Accurate instructions. EKD vice-president, the Protestant bishop Jochen Bohl, highlighted the document’s improvements. In fact, as compared to the previous version, the new document “clearly highlights the role of the chosen health care representative, i.e. the advance proxy appointment”, and “it contains further details on medical treatment directions”. An important sign for ecumenism. ACK President Friedrich Weber said, “Cooperation between Christian Churches was successful also on this issue”. With the Christian Advance Directive “Churches have once more jointly conveyed Christian faith and its ethical guidelines. It is an important sign in view of certain controversial themes among Churches, since it shows that Churches need, complete and mutually enrich one another”.