'Letting Go -- The Dilemmas at Life's End'

October 24, 2011

Death remains as implacable as ever, but the context in which most deaths occur has changed profoundly in recent times. In our age, death is much less likely than in the past to come "like a thief in the night". Thanks to modern medical technology, only one-third of deaths in industrialized countries are unanticipated. The others are expected, and occur under medical supervision, and most require medical decisions. In a new book entitled "Sterben lassen. Über Entscheidungen am Ende des Lebens" ("Letting Go. Decisions at the End of Life"), LMU clinician Ralf J. Jox, MD, PhD, considers the ethical and legal dilemmas posed by this new form of "supervised death". These issues arise because the relatives of the terminally ill, and their doctors, frequently find themselves having to decide whether to administer medical treatment, which may not be advisable under the circumstances, or let nature take its course.

Jox writes in his book about the anguish caused by these dilemmas - and none of us can be certain of avoiding such a harrowing choice - and about the role of personal autonomy in the final phases of life. He outlines the legal context and the relevant medical indications, discusses suicide and assisted suicide, and ethics consultation services. The author draws on his personal experience in palliative medicine (the primary goal of which is to ensure that the terminally ill do not experience unnecessary pain in the final phase of their lives) to provide a detailed survey of palliative care in Germany.

"We must all face decisions concerning the when and how of dying - not just our own death, but also, and perhaps even more urgently, the deaths of others," writes Jox. "It may be a matter of having to decide whether or not a grandmother suffering from dementia should be fed through a PEG tube, or a husband with heart disease should undergo a risky cardiac catheterization procedure, or even whether one's child who has been severely injured in a traffic accident should be artificially ventilated." His book offers practical advice on how to reach responsible decisions in such difficult circumstances.
„Sterben lassen. Über Entscheidungen am Ende des Lebens"
Ralf J. Jox
Edition Körber Stiftung, 268 pages, October 2011
ISBN: 978-3896840875

Dr. Ralf Jox
Institute for the Ethics, History and Theory of Medicine
LMU Munich
Phone: 089-5160 - 2620
Email: ralf.jox@med.uni-muenchen.de

Ludwig-Maximilians-Universität München

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