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:

• Third Act amending theGuardianship. From 29 July 2009 (gm): http://www.bmj.bund.de/files/-/3906/Drittes_Gesetz_Aenderung_Betreuungsrecht_Bundesgesetzblatt.pdf

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

• Living will (en): Section1901a.

• Discussion to ascertain thepatient’s will (en): Section1901b.

• Wishes in writing with regard to custodianship, enduring power of attorney (en): Section1901c.