[Ethical dilemmas in geriatric psychiatry]

In a review of the literature the author outlines the basic ethical problems of contemporary European gerontopsychiatry, as apparent at international congresses of gerontopsychiatric societies in Berlin (1993 and 1994) and Amsterdam (1994). Ethical dilemmas include in the first place abuse of old people, ethics of drug trials with insane patients and the right of a dignified death of psychiatric patients in general and insane patients in particular. The author holds a critical view of the legalization of euthanasia. A substantial part of the paper is devoted to the development of discussions regarding the legalization of euthanasia in Holland. It seems that as long as euthanasia will be restricted to the terminal stages of generalized malignities, it could be adopted also in other European countries incl. the Czech Republic. The author has a very critical and negative attitude to frequently practised dysthanasia, not only in the mentally healthy but also in psychiatric patients. He refutes inadequate medical intervention from the sphere of heroic medicine in particular in insane patients in the terminal stages of degenerative brain diseases.