Living will

The doctor and the patient work together in the treatment: The doctor determines what is medically indicated, informs the patient about it and offers him/her a treatment. The patient decides whether he/she consents to this treatment. The doctor may not treat the patient against his/her will. This also applies to life-sustaining and life-prolonging measures.

However, even if the patient is no longer capable of giving consent, his or her right to self-determination requires that his or her wishes be respected. If there is no clear, prior expression of the patient's will, his/her representative (health care proxy or guardian) must decide according to the "presumed will of the patient".

It is obvious that determining the presumed will of another person can be very difficult. Therefore, you should deal with these questions in good time and try to be clear about your own values and wishes. With a living will, you can make provisions and determine yourself whether and which medical measures should be carried out if you are no longer capable of making decisions.

In a written living will, adults who are capable of giving consent can determine in advance whether and how they want to receive medical treatment later if they are no longer able to express their will themselves. A person is capable of giving consent if he or she can understand the nature, significance, scope and risks of a medical measure and its rejection, and can direct his or her will accordingly.

The content of the living will refers to concrete situations and provisions regarding medical treatment measures. These include, for example, examinations of the state of health, curative treatments or medical interventions.

The more precise the provisions are, the better they can be carried out according to the patient's will. It is possible to demand, restrict or completely refuse treatment.

To ensure that an advance directive can be interpreted according to your will even in the case of treatment measures that are not specified, it should also contain individual wishes as well as values. The advance directive must be in writing and signed by your own hand or by a hand sign certified by a notary public.

Note: If you are incapable of making decisions yourself, close relatives and confidants, such as spouses, siblings, children or partners, can only make decisions regarding examination, care or treatment despite the existence of an advance directive if a power of attorney is available.

The person who is to make decisions in your place or enforce the decisions you have made in advance is not specified in the living will. This is a key difference to a health care proxy or care directive.

The living will only serves to implement your will on pre-determined medical treatment methods.
A health care proxy, on the other hand, specifies who is to act as your proxy to make medical or other orders on your behalf.
However, you can combine the living will and a health care proxy by specifying in your health care proxy which person is to enforce and observe the living will you have made. Living wills and health care powers of attorney therefore complement each other and can therefore be drawn up side by side.

You have the option of registering your living will in conjunction with a health care proxy with the Central Care Register.
It is advisable to keep the living will in such a way that the doctor, authorised representative, guardian and guardianship court can quickly and easily obtain knowledge of the existence and storage location of the living will. To this end, it makes sense to always carry a corresponding note with you, ideally with your identification papers.

See also

• Registration of the power of attorney for precaution or care directive in the central precautionary register