By Matthias Thöns
Matthias Thöns reports on a legal case concerning an 82-year-old nursing home resident with advanced dementia who had been fed through a PEG tube for years. The treating physician later considered him a palliative patient, yet artificial nutrition and other interventions continued despite severe suffering.
The patient’s son sued the family doctor. The court regarded the continuation of PEG nutrition without a therapeutic goal as a treatment error because the physician should have informed and discussed with the legal guardian that no therapy goal beyond mere life prolongation was achievable.
The article explains why the decision is considered a milestone in medical law. For the first time, a higher court stated that artificial life extension by feeding tube in severely suffering patients without a therapeutic goal can be medically non-indicated. It also fits into a wider debate about overtreatment, economic incentives and non-beneficial interventions at the end of life.
Thöns summarizes the legal logic: first, a physician must examine whether an indication exists and whether a treatment goal desired by the patient can realistically be reached. Then treatment requires information and valid consent. The article distinguishes current will, advance directives, treatment wishes and presumed will.
