Acronyms of Dying versus Patient Autonomy

in European Journal of Health Law
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In medical practice in Germany and several other countries abbreviated orders linked to end-of-life decisions, such as DNR (do not resuscitate), are increasingly used. In order to investigate their legal status, this article gives an overview of the recently passed German law, which regulates the process of end-of-life decision-making and the use of living wills, giving primacy to patient autonomy. Concerning the risk of misinterpretation of acronyms, the article describes the impacts of such orders on patient autonomy and safety and suggests a clear systematic classification of the different DNR orders in order to investigate their legal status under the German law. Their general binding force is to be acknowledged, depending on its origination and the fulfilment of certain requirements.

Acronyms of Dying versus Patient Autonomy

in European Journal of Health Law




D.A. Sherman and K. Branum“Critical care nurses’ perceptions of appropriate care of the patient with orders not to resuscitate”Heart & Lung 24(4) (1995) 321-329.


E.g. Jill Armentrout“Michigan residents take charge of their end-of-life plans.” The Associated Press State & Local Wire5 June 2006; Kathie Durbin and Zachary Kaufman “A choice in dying: When they go all the pieces are aligned.” The Columbian 13 July 2008 p. A4; J.E. Farrow 1997. “Whose Life Is It Anyway?” Newsweek 3 November p. 25.


J. TaupitzEmpfehlen sich zivilrechtliche Regelungen zur Absicherung der Patientenautonomie am Ende des Lebens? Gutachten A für den 63. Deutschen Juristentag 2000 (München: Beck2000) pp. A 60 et seq.


Bundestag printed paper no. 16/13314 p. 4.


M.C. Beach and R.S. Morrison“The Effect of Do-Not-Resuscitate Orders on Physician Decision-Making”Journal of the American Geriatrics Society 50(12) (2002) 2059; Henneman et al. ibid. p. 467.


Sherman et al.supra note 5 p. 322 with further references.


A.D. Katsetos and F.L. Mirarchi“A living will misinterpreted as a DNR order: confusion compromises patient care”The Journal of Emergency Medicine 40(6) (2011) 629.


S. Mayor“New UK guidance on resuscitation calls for open decision-making”British Medical Journal 322(7285) (2001) 509; E. Shah “Do not resuscitate decisions: flogging dead horses or a dignified death?: Resuscitation should not be withheld from elderly people without discussion” British Medical Journal 320(7243) (2000) 1155; Helen Rumbelow 2000. “Patients demand ‘living wills’ to protect elderly” The Times 14 April; Glass v. UK [2004] ECHR application no. 61827/00 (9 March 2004).


R. Beckmann“Patientenverfügungen: Entscheidungswege nach der gesetzlichen Regelung”Medizinrecht 27(10) (2009) 585; Taupitz et al. supra note 14 p. 349.


T. Diehn and R. Rebhan“Vorsorgevollmacht und Patientenverfügung”Neue Juristische Wochenschrift 63(6) (2010) 330 et seq.


A.T. May and J.C. Brokmann“Medizinische und medizinethische Grundlagen der Vorsorgemöglichkeiten”Der Anaesthesist 59(2) (2010) 122; G. Müller “Die Patientenverfügung nach dem 3. Betreuungsrechtsänderungsgesetz: alles geregelt und vieles ungeklärt” Deutsche Notar Zeitschrift 105(3) (2010) 178; K. Ulsenheimer “Neue Regelung der Patientenverfügung” Der Anaesthesist 59(2) (2010) 115.


H. Kreß“Patientenverfügungen und Selbstbestimmung in Anbetracht der Notfallmedizin”Zeitschrift für Rechtspolitik 42(3) (2009) 70.


Compare: Beckmannsupra note 27.


L. Doyal and D. Wilsher“Withholding cardiopulmonary resuscitation: proposals for formal guidelines”British Medical Journal 306(6892) (1993) 1594.


A. Simon“Patientenverfügung in der Intensiv- und Notfallmedizin”Intensivmedizin und Notfallmedizin 47(1) (2010) 43.


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