[Management of treatment omission. Ethical problems in terminal care]

Causes and courses of the diseases are subjected to a change of an increasing life expectancy on the one hand and technically highly developed medicine on the other hand. Since a growing number of elderly people is denying intensive medical interventions which serve the purpose of keeping them alive despite severe diseases, the problem of euthanasia imposes direct questions. A central role is played by the active-passive difference and its moralistic legitimacy. The difficulties of this difference are discussed below on the applicable level of ethical discussions. At the same time, knowledge of the danger is being made aware that in a maximal therapeutical orientated medical care system the desire for euthanasia may become identical with the reverse side of this care system.