[Legal ramifications of medical end-of-life decisions in dementia--orientational certainty through the latest decisions of the German Supreme Court?].

Taking care of dying people is one of the most difficult obligations of the physician, especially if these patients are suffering from dementia and accordingly when their current capacity to consent is arguable. In this field, numerous ethical and forensic problems arise that have to be considered. Legal medical end-of-life decisions that potentially shorten life (Sterbehilfe) are divided into two categories: direct "Sterbehilfe" refers to stopping life-prolonging measures. Indirect "Sterbehilfe" describes the use of agents to alleviate symptoms of a terminally ill patient which may however, shorten life expectancy. A physician terminating a patient's life based on his own decision and authority of action always acts illegally. This paper describes the current discussion on this issue in Germany considering the medical and legal aspects of it while focussing on patients suffering from dementia and their ability to form and to articulate their own will. © Georg Thieme Verlag KG Stuttgart · New York.