Prospects at the Final Stages of Life

Abstract

General Description and Social Relevance

It is a common known fact that human life expectancy is steadily increasing due to improved hygienic conditions, dietary measures, social circumstances and medical treatment. Subsequently tribulations on grounds of age are multiplying, and more and more emphasis is put on the question for an arranged end of life.
In view of these developments „dying in dignity“ creates challenges for a broad range of sciences. It faces for example questions of medical care and nursing, legal fields and sociology. It simply has become a problem of the general public.
Moreover this question does not only relate to the phenomenon of an aging society, it also arises in cases of serious disease and persistent vegetative state as well as for children and adolescents, suffering from incurable diseases and also within the neonatology unit. Against the background of individualistic ethics, focusing on the dignity of every human being, exceedingly criticized eugenic approaches are discussed with particular reference to new-born infants and adolescents with special needs in direct relationship to a prearranged end of life (cf. Groninger Protokoll). Thus life may end at any time. Personal biographies and self-determination may be affected by a remaining uncertainty about the time of death on the one hand, and the certain expectation of impending death on the other.
  Thereby the end of life comes into conflict with self-determination and public care. In its essence care is something supportive and considered as positive. But providing assistance also implies that the power of decision can be taken over by another person or institution. Consequently public welfare may reveal a considerable restrictive and paternalistic character, when it comes to those who are affected.

Social Relevance and Unique Feature

The Austrian parliamentary enquete-commission with the title „dignity at the end of life” shows the high social impact of this topic. During the last years the ethical review committee of the Austrian Office of the Federal Chancellor has issued a range of official statements regarding to, for instance, patient’s provisions, transplantation medicine etc. The social importance reaching beyond the borders of Austria is reflected by the recommendation of the Council of Europe regarding the protection of human rights and the dignity of terminally ill and dying persons. The presented results in the so-called “position paper” by the enquete-commission are no final conclusions and give cause to deeper analysis.
Within the framework of this college there shall not only be a discussion “whether” there should be an arranged end of life, but also “how” a planned end of life could look like. The entire stage until the end of life and predestinated fields of preparation, like the legal segment about health care proxies and patient’s provisions, shall comprise the subject of this college.