For the various phases of processing patient-related data (storage, modification, transfer, deletion and use) and data security, the valid directives of the Federal Data Security Act (Bundesdatenschutzgesetz, BDSG) and the various special regulations (e.g. SGB V, SGB VII, SGB IX) for data processing shall be complied with and the necessary technical and organizational measures taken.
'Involuntary' means against the wishes expressed by a competent person or through a valid advance directive.
'Voluntary' means in accordance with the wishes expressed by a competent person or through a valid advance directive.
'Non-voluntary' means without the knowledge of the wishes expressed by a competent person or through a valid advance directive.
The person making the request for assisted suicide or euthanasia must be competent or, while competent, must have expressed the wish for voluntary euthanasia through a valid advance directive.
In the UK, if a person lacks capacity to make their own medical or social decisions, the Mental Capacity Act mandates that (except when a valid advanced directive is in place) a relative who has been given lasting power of attorney makes such decisions.
When death is not imminent and inevitable, withholding or withdrawal of artificial nutrition and hydration in mentally incompetent patients without valid advance directives requires additional procedural safeguards.
Canadian courts and statutes have also clarified that health care professionals must respect refusals made on behalf of incompetent persons, without valid instruction directives, by their legally authorized substitute decision-makers.
115 It can therefore be concluded that there is considerable clarity and very little controversy concerning the law as it relates to withholding and withdrawal of potentially life-sustaining treatment from competent adults, or on behalf of incompetent persons without valid advance directives by their legally authorized substitute-decision-makers.
The directive is valid if signed by a notary public or by two witnesses.
