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Germany


 
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sobre

The territory of Germany covers 357,021 km². With over 82 million inhabitants, it comprises the largest population among the member states of the European Union

Germany has the second largest population in Europe (after European Russia) and is the seventh largest country by area. The territory of Germany covers 357,021 km² (137,847 sq mi), consisting of 349,223 km² (134,836 sq mi) of land and 7,798 km² (3,011 sq mi) of water.  

A complete description of the German Health Care System available online at:

World Health Organization - Regional Office for Europe



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panoramica

panoramica

Advance directives are regulated by law in Germany since 29 july 2009 . The Federal Law amends the Civil Code so that AD are binding but only if they are according with the patient’s current living and treatment.

ADs in German can be named as:

  • Patientenverfügung
  • Behandlungswünsche
  • Behandlungsvereinbarung (for psychiatric patients))
  • Every person of full age (18years and older) who is able to consent has the right to set a living will.
  • A living will must be in writing, it takes effect when the person is no longer able to consent but only if these determinations correspond to the current living and treatment situation.
  • A living will is possible regardless of the nature and stage of any illness of the person. It is not necessary to suffer a lifetime limiting illness.
  • A living will may be revoked at any time without a specific form.
  • No one may be obliged to establish a living will.
  • The physician in attendance must examine which medical measure is indicated with regard to the patient’s overall condition and prognosis. He and legal representative (representative or legal guardian) must discuss this measure, considering the patient’s will (1. direct binding living will, 2. interpretation of the living will or 3. presumed will) as a basis for the decision to be taken.
The German law guarantees the autonomy of the patient. Nevertheless the legal guardian (Betreuer) or the authorised representative (Bevollmächtigter) have to examine whether these determinations correspond to the current living and treatment situation.

If there the determinations of a living will do not correspond to the current life and treatment situation, the legal representative must determine the wishes with regard to treatment or the presumed will of the person.

Furthermore if there is no living will the presumed will (mutmaßlicher Wille) must be ascertained on the basis of concrete indications. Consideration must be given, in particular, to previous oral or written statements, ethical or religious convictions and other personal values of the person under custodianship.

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legislacion
legislacion

Although advance directives were a fact in Germany, theywere no binding until the law amending guardianship came into force in July2009.

Since 2004, a report entitled Patientenautonomie am lebensende (the Autonomy of the Patient at the End of Life) existed within the Ministry of Justice. This bill, which implied a change to Civil Code, has derived in the current law that rules definitively AD.

The new Federal Law is available at thefollowing link:

German Civil Code with approved changes is available at the following links:

  • Discussion to ascertain thepatient’s will (en): Section1901b.
  • Wishes in writing with regard to custodianship, enduring power of attorney (en): Section1901c.

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como registrar una voluntad anticipada
registro

There is no official procedure for registering an AD in Germany.

Although no data on the use of ADs exists, they appear to be gaining ground in terms of popularity and acceptance amongst patients and doctors. An Emnid-survey from 2000 states that 81% of Germans would like to prepare an advance directive. The primary reason for most people is that they are afraid of overtreatment by medical instruments.
It is further stated that in 2005 8,6 million people (approx. 10% of the German population) had prepared an advance directive.

There is no official registry but exists the possibility of filing the living will and/or the registration of a health care proxy with the Federal Chamber of Notaries.
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formularios

formulario

AD forms are available at:


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informacion

legislacion

More information about Advance Directivesin Germanycan be found in the following links:


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