The German Association of Statutory Health Physicians (KBV) has ignited a sensitive and potentially contentious debate regarding the limits of intensive medical treatment for severely ill patients, particularly those nearing the end of life. Andreas Gassen, Chairman of the KBV and a former emergency physician, acknowledged the complexity of the issue in an interview with the “Neue Osnabrücker Zeitung”, prompting a wider discussion about the ethics of maximizing medical interventions regardless of patient benefit.
Gassen’s remarks follow statements by CDU health policy spokesman Hendrik Streeck, who raised concerns about the allocation of costly medications to elderly individuals. While rejecting any cost-benefit or age-based rationale for restricting treatment, Gassen underscored the deeply problematic nature of assigning a monetary value to human life, noting that serious illness does not disproportionately affect the elderly.
A core concern raised by Gassen is the tendency towards reflexive, exhaustive medical application, even when it serves no clear palliative purpose. He highlighted the psychological toll on physicians who grapple with the perceived failure of delivering curative or life-extending treatment and the inherent difficulty in accepting the natural progression of terminal illness.
While acknowledging that patients generally live longer, Gassen observed a concerning trend of delaying palliative care and prolonging intensive medical interventions, suggesting a potential over-reliance on technology. Notably, he cautioned against legislative intervention, emphasizing the critical need for open and sensitive dialogue amongst medical professionals and patients’ families.
Ultimately, Gassen stressed that decisions regarding end-of-life care should be guided by patient autonomy when possible. However, he highlighted the challenging role of physicians in providing advice – for example, the difficult conversation recommending hospice care versus continued intensive treatment. He concluded with a pointed warning against the “commercialization of death” suggesting that the pursuit of prolonged life, irrespective of quality or patient wishes, risks eroding ethical medical practice and potentially burdening the healthcare system as a whole. The debate promises to be fiercely contested, posing fundamental questions about the values underpinning German healthcare.
