[End-of-life decision-making].

Innere Medizin (Heidelberg, Germany) Pub Date : 2024-10-01 Epub Date: 2024-09-16 DOI:10.1007/s00108-024-01770-8
Andreas Kruse
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Abstract

The article begins with a reflection on the intertwined nature of life and death; this reflection should also serve to sensitize us to the proactive and reactive expressions of a person's life at the end of life. It will be shown that attachment to life can also manifest itself in the case of depression, fear and exhaustion: One must not lose sight of their potential existence. The existing commitment to life allows us to better understand why the remaining time of life may be perceived as something precious; this may be in contrast to statements made in the living will. A distinction is made between subjectively, objectively and socially defined criteria for a good life in the borderline situation of a serious illness leading to death; their comparison is central to the end-of-life decision-making process. In addition to physical and neurocognitive illnesses, suicidality is at the centre of the article.

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[临终决策]。
文章首先对生死交织的本质进行了反思;这一反思也应有助于使我们认识到一个人在生命终结时对生命的主动和被动表达。这将表明,对生命的眷恋也可以表现为抑郁、恐惧和疲惫:人不能忽视自己潜在的存在。对生命的现有承诺使我们能够更好地理解为什么剩余的生命时间会被视为宝贵的东西;这可能与生前遗嘱中的陈述形成对比。在重病导致死亡的边缘情况下,对主观、客观和社会界定的美好生活标准进行了区分;它们之间的比较是临终决策过程的核心。除身体和神经认知疾病外,自杀也是文章的中心内容。
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