[Ethical considerations in 2005 on geriatric patients' end of life]

Geriatric medicine is challenged by new ethical questions with regard to demographic changes and medical progress. Aged patients deserve the full range of modern medical care, but they also have the right to die in dignity when their time has come. The decision whether a therapeutically active or passive approach should be preferred depends on the disease with its symptoms, functional deficiencies, and prognosis, and especially on the patient's will which has to be evaluated thoroughly, eventually with the help of his family. In any doubt, life deserves preference, but in cases with a bad prognosis medical interventions like intensive care, tube feeding, resuscitation, etc. may be excluded in order to maintain life quality (e. g. through pain control), avoid suffering, and allow peaceful dying. Despite the geriatrician's personal responsibility for all medical measures, his decisions should be explained and accepted by the geriatric team and the patient's family. Patient's welfare clearly needs to be preferred to disease management or economic considerations.