Nichtaufnahme und Abbruch einer medizinischen Behandlung am Lebensende in Deutschland und England

This article analyses the law relating to withholding and withdrawing life-prolonging medical treatment in Germany and England & Wales. Recent case law from both jurisdictions is considered and contrasted with jurisprudence from the United States of America. Whilst all three jurisdictions recognise the ability of a competent patient to refuse life-prolonging treatment, it is argued that the models of decision-making adopted in relation to patients lacking capacity are inherently flawed. It is suggested that where the patient lacks capacity, neither the autonomy model of decision-making (encompassing the presumed will approach adopted in Germany and the substituted judgement approach adopted in the USA), nor the best interests model (adopted in England & Wales) can adequately protect the interests (particularly the ‘critical’ interests) of the affected individual.