Strict regulation

Genetic testing of embryos, organ donation, assisted suicide: The German Medical Congress in Kiel, which ended on Friday, redefined the position of the medical profession on important ethical ies.

With a large majority, the 250 delegates on Wednesday evening spoke out in favor of an explicit ban on medical assistance in suicide. At the same time, they called for a strengthening of palliative care for the terminally ill.

Also with a large majority, the Physicians' Congress pleaded for a strictly limited use of the controversial pre-implantation diagnostics (PID). At the same time, the Physicians' Congress called for changes to the transplantation law. To attract more potential organ donors, every citizen should be asked to declare his or her position on organ donation.

"Physicians are to assist the dying with respect for their dignity and with respect for their will. They are forbidden to kill patients at their request. They are not allowed to provide assistance in suicide," states the new version of the medical professional code of conduct on assisted suicide, which was passed by a large majority of the Medical Congress. The professional code of conduct, which is legally binding for all physicians, did not include an explicit ban on assisted suicide.

Dealing with seriously ill and dying people was also the focus of discussions on the future shape of palliative medicine. Unanimously the delegates spoke out in favor of integrating palliative medicine comprehensively into outpatient and inpatient care. The further expansion of chairs for palliative medicine at medical faculties is also necessary. For a good two years now, palliative medicine has been a compulsory teaching and examination subject in medical studies. However, there are still deficits in implementation.

On the subject of PGD, the Physicians' Conference decided that "the ethical balance is in favor of permitting PGD within narrow limits and under controlled conditions". PGD should be offered to couples whose offspring are at high risk of a familial and serious genetic disease. Tests for sex determination without disease reference or to limit the risk in elderly parents should not exist.

PGD involves testing fertilized eggs created in a test tube outside the womb for genetic errors and destroying damaged embryos. In Germany, it was long considered forbidden according to the current legal interpretation of the Embryo Protection Act. However, the Federal Court of Justice (BGH) overturned this catch-all in July 2010. The Bundestag plans to pass a law on PGD this summer. Three bills are before parliament: One provides for a complete ban, the remaining two want to allow the method in different limits.

At the same time, the delegates of the Physicians' Congress demanded reforms in the regulation of organ donation. In particular, the population must be better informed about the possibilities of transplantation medicine, according to a resolution of the medical parliament. As many citizens as possible should declare their willingness for organ and tie donation. However, the citizens' right to self-determination must be preserved.

The delegates thus follow the proposal of the Standing Commission on Organ Transplantation of the German Medical Association, which has developed the so-called "model of an information and self-determination solution with an obligation to declare". It is widely in line with proposals of high-ranking politicians such as the leaders of the parliamentary groups of the CDU/CSU and SPD in the Bundestag, Volker Kauder and Frank-Walter Steinmeier. They want every citizen to be asked during their lifetime about their stance on organ donation. The answer should then be recorded in a personal document such as a driver's license.

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