[Patient self-determination--reflections on critical and responsible management]

The assumption on which this article is based is that Living Wills represent possible protection against medical and nursing treatments which are detrimental to one's own well-being in the phases of life in which one is no longer or only to a very limited extent capable of making decisions onself. But Living Wills cannot afford protection against grave strokes of fate and safeguard a life of self-determination until death. A Living Will can only constitute a helpful protective function, not only for the sick person but also for all those involved in his/her treatment and care, if it is discussed extensively with others so that these persons can interpret its meaning with respect to medical and nursing treatment in the sense intended by the patient. The article provides indications as to how Living Wills and their handling can best make this protective function possible.