P-296: Senior citizens and 10 years of palliative care and euthanasia: ethical reflexions on a successs story or on a burden to full autonomy?

摘要

(1) Since march 2009 our country has passed two laws : on the right to access to palliative care wherever the elderly persons lives and on the right to ask for euthanasia. We wanted to find out, how far the elderly persons can fullfill these wishes and what are the burdens they are still facing. (2) When we compare the results published every year concerning these two aspects of care (in a way of autonomy up to the last period of life), we found inequalities of access for the seniors requests. In palliation, 80% of the elderly (80 ? years) in institutions have care plans for dependency, but the institution refuses to ask for specific palliative care plans, as they are financially less attractive. On the other side, the will for euthanasia is difficult to accomplish (212 registered demands for persons 70 + years), because only 10-15 elderly die through euthanasia per year. (3) What hinders senior patients to achieve their rights? Palliative care plans are dependant on each institution and are not allocated directly to senior residents. In case of euthanasia, the most important difficulty is still the physician's attitude (all euthanasias were done by specialists and in hospitals), as the general practitioners are mostly in contact over a life-period, they should have the greatest awareness to the patient's suffering. (4) In conclusion the senior patient's will and his autonomy has to be put in the centre of all medical and institutional concerns.