Die vorliegende Arbeit befasst sich mit der Kenntnis über Patientenverfügungen sowie deren Akzeptanz und dem Vorhandensein dieser Vorsorgedokumente innerhalb eines Studienkollektives von Senioren in Leipziger Alten- und Pflegeheimen. Der Gegenstand der Patientenverfügung selbst wird, unter Berücksichtigung soziodemographischer, persönlicher sowie gesundheitlicher Aspekte, evaluiert. Außerdem werden Standpunkte der Heimbewohner wie beispielsweise die Bereitschaft zu lebensverlängernden Therapien sowie zu Reanimationsmaßnahmen hinterfragt. Vor dem Hintergrund der Ergebnisse werden Lösungsmöglichkeiten diskutiert, welche die Grenze zwischen medizinisch-technisch Möglichen und ethisch Vertretbarem bezüglich der Entscheidungen am Lebensende regulieren können.

The aim of this thesis is to clarify the concept of the right to life in the legislative in the Czech Republic and in abroad with a comparison with its unnatural end, while abortion and euthanasia. This work is primarily devoted to law regulation of these institutes, but also covers other aspects such as religion, philosophy and science. It is designed so that each and every chapter is in its introductory section devoted to the formulation of the topic, the historical development in the Czech Republic but also abroad, it introduces the possible procedures and attitudes, it mentions for example and briefly compares similar institutes. Other parts of the diploma deal with legislation whether the right to life, abortion or euthanasia, provides comparison of domestic legislation with internationals. In light of the judgments of the European Court of Human Rights points the views and attitudes on the subject at the international level. The final section is then evaluated core issues especially from the standpoint of law.

A dignidade da pessoa humana e a autonomia privada espraiam-se pela experiência da vida, alcançando a doença e a morte. As diretivas antecipadas, gênero dos quais são espécies o testamento vital e o mandato duradouro, constituem negócio jurídico de caráter existencial que têm por objetivo assegurar a realização da dignidade da pessoa e o cumprimento dos atos de autonomia nas situações em que a pessoa estiver incapacitada para manifestar sua vontade. As diretivas representam instrumento de autodeterminação através do qual a pessoa disciplina os tratamentos médicos que aceita ou não ser submetida, autoriza doação de órgão, estipula se tem interesse em conhecer seu estado clínico e/ou nomeia terceira pessoa para tomar estas decisões em seu lugar. As três primeiras hipóteses constituem o que usualmente se qualifica como testamento vital, enquanto a última situação descrita configura o mandato duradouro. O objeto de estudo abrange a evolução das diretivas antecipadas, a disciplina existente em países que já regulamentaram o tema, a legitimação no sistema jurídico brasileiro (o que autoriza a conclusão favorável a sua utilização independentemente de lei expressa) e a sistematização deste negócio jurídico perante o ordenamento jurídico. / Human dignity and autonomy get extended through life, reaching illness and death. The advanced directives, which species are the living will and durable power of attorney, represent an existential act aimed to fulfill human dignity and to preserve ones autonomy when lacking the ability of transmitting ones desire personally (disability). The advance directives are an instrument of self-determination that may contain clauses to withheld or withdraw medical treatment, authorize organ donation, discipline the right to know ones medical condition and to indicate an attorney for health care, to whom will be delegate those decisions. The object of study covers the evolution of the advance directives, their discipline in the countries that already legislate about it, the source of legitimation in brazilian Law system (what includes a positive understanding on its usage even though without a specific law) and the guide lines of the act, such as form and legitimacy.

A dignidade da pessoa humana e a autonomia privada espraiam-se pela experiência da vida, alcançando a doença e a morte. As diretivas antecipadas, gênero dos quais são espécies o testamento vital e o mandato duradouro, constituem negócio jurídico de caráter existencial que têm por objetivo assegurar a realização da dignidade da pessoa e o cumprimento dos atos de autonomia nas situações em que a pessoa estiver incapacitada para manifestar sua vontade. As diretivas representam instrumento de autodeterminação através do qual a pessoa disciplina os tratamentos médicos que aceita ou não ser submetida, autoriza doação de órgão, estipula se tem interesse em conhecer seu estado clínico e/ou nomeia terceira pessoa para tomar estas decisões em seu lugar. As três primeiras hipóteses constituem o que usualmente se qualifica como testamento vital, enquanto a última situação descrita configura o mandato duradouro. O objeto de estudo abrange a evolução das diretivas antecipadas, a disciplina existente em países que já regulamentaram o tema, a legitimação no sistema jurídico brasileiro (o que autoriza a conclusão favorável a sua utilização independentemente de lei expressa) e a sistematização deste negócio jurídico perante o ordenamento jurídico. / Human dignity and autonomy get extended through life, reaching illness and death. The advanced directives, which species are the living will and durable power of attorney, represent an existential act aimed to fulfill human dignity and to preserve ones autonomy when lacking the ability of transmitting ones desire personally (disability). The advance directives are an instrument of self-determination that may contain clauses to withheld or withdraw medical treatment, authorize organ donation, discipline the right to know ones medical condition and to indicate an attorney for health care, to whom will be delegate those decisions. The object of study covers the evolution of the advance directives, their discipline in the countries that already legislate about it, the source of legitimation in brazilian Law system (what includes a positive understanding on its usage even though without a specific law) and the guide lines of the act, such as form and legitimacy.

This dissertation aims to examine and analyse the current South African position with regard to voluntary euthanasia. An examination is made from constitutional law, common law, case law and statutory law perspectives, including the legislation proposed by the South African Law Commission (project 86). The writings of prominent authors are considered. Once the South African position is examined, a comparative study is undertaken concerning relevant aspects in the Dutch law. The most important findings are that the South African Constitution may allow, and perhaps even demand, the legalization of voluntary euthanasia in South Africa, provided that sufficient safeguards can be established to effectively and sufficiently minimize the risk of abuse. Should this be impossible, the proscription of euthanasia may be reasonable and justifiable in an open and democratic society based on human dignity, equality and freedom. Finally, some recommendations are made for changes to the South African Law Commission’s Final Draft Bill. / Dissertation (LLM (Medical Law))--University of Pretoria, 2008. / Public Law / unrestricted

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The number of individuals aged more than 65 years in the United States and their life expectancy has been increasing in the past decades. In spite of the presence of federal and accreditation policies recommending completion of advance directive documents by patients admitted to health care settings, advance directive completion rates are low in most health care organizations. The purpose of this study was to determine the level of advance directive completion among home health patients. The health belief model provided the theoretical framework that guided this study. A retrospective chart review was carried out in a home health agency with about 51 patients. Demographic details, including age, gender, ethnicity, nature of illness and type of health insurance were collected. Descriptive statistics were used to determine the percentage of home health patients with existing advance directives and those who do not have an advance directive. The study revealed that only 25% of the patients in the home health care agency had a completed advance directive. The finding indicate a disconnect between the recommended and the actual practice with regards to end of life issues. There is a pressing need for more complete documentation of the patient's desires and wishes regarding end of life care at home health care facilities. Documenting the patient's end of life preferences and wishes may potentially ease the decision-making process, making the end of life days less stressful for the patients and their families at the same time promoting the provision of personalized health care at the end of life.

This study examined the relationship between demographics, attitudes, and subjective norms (influences) on Virginia adults over 50 with at least one adult child and the presence of estate planning documents. The Theory of Reasoned Action (Azjen & Fishbein, 1980) was applied using a secondary data set of 189 participants. Regression analyses examined paths from external variables (demographics), attitudes toward the behavior, and subjective norms to the intention and behavior. Intention and behavior were defined as the possession, intention to possess, and non-intention to possess estate planning documents. Asset-focused documents included Will, Living Trust, Durable Power of Attorney for Financial Issues, and the Letter of Instruction. Health care-focused documents included Living Will and the Durable Power of Attorney for Health Care. An analysis was also conducted on the possession of a complete set of estate planning documents. Older persons were more likely to possess all documents except the Letter of Instruction. Respondents with higher assets were more likely to possess a Will. Respondents who were more educated were more inclined to possess a Living Will. Respondents that had informally promised property to their children were more likely to possess a Living Trust. Younger respondents were more likely to intend to possess a Will, the Durable Power of Attorney for Health Care, and the Living Will. Persons with lower assets were more likely to intend to possess a Will, and those with a goal for privacy in financial affairs and who believed they should help their adult children financially were more likely to intend to possess a Living Trust. Participants who intended to possess a Letter of Instruction were more educated, male, owned homes, and had a goal for privacy in financial affairs. Age (younger) was an indirect influence to the Letter of Instruction, mediated through the goal to leave family financial security. Participants with lower assets and in good emotional health did not have intention to possess a Living Trust. Male gender and owning a home were influences on not intending to possess a Durable Power of Attorney for Financial Issues. Males were less likely to have a Letter of Instruction. Respondents with the goal to leave an inheritance were more likely to have non-intention to possess the Durable Power of Attorney for Health Care and Durable Power of Attorney for Financial Issues. More education, lower income, and residing with a relative were mediated influences to the Durable Powers of Attorney for Health Care and for Financial Issues through the goal to leave inheritance. Respondents that were older, had more assets, owned homes, had a goal to leave an inheritance, and that had informally promised their property were more likely to possess more estate documents. Indirect paths to having a set of estate planning documents were more education, lower income, and residing with a relative, which were mediated through the goal to leave inheritance. The low number of estate planning documents respondents had and the lack of intention to obtain estate planning documents indicate a need for further education in the areas of estate planning. The occurrence of older age as an influence, particularly with health care-focused documents, indicates a need for more awareness in younger adults of their vulnerability, at any age, to illness or injury and that medical directives should be in place. / Ph. D.