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Selbstbestimmung Wider Das Universelle Tötungsverbot

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Selbstbestimmung Wider Das Universelle Tötungsverbot Selbstbestimmung wider das universelle Tötungsverbot: Betrachtungen zu medizinischen Entscheidungen am Lebensende und Ausnahmen vom generellen Lebensschutz in Deutschland, Schweiz und den Niederlanden Dissertation zur Erlangung des Grades eines Doktors der Philosophie an der Philosophischen Fakultät der Technischen Universität Dresden vorgelegt von Matthias Forßbohm Geb. am 24.11.1981 in Freiberg ('achsen) )etreuer* Prof. Dr. Dr. )ernhard ,rrgang (Technische Universität Dresden( Erstgutachter* Prof. Dr. Dr. Bernhard ,rrgang (Technische Universität Dresden) -.eitgutachter* Prof. Dr Dr. Thomas Rentsch (Technische Universität Dresden) Tag der Verteidigung* 05.07.2017 Inhalt Abkürzungsverzeichnis ......................................................................................................................... IV Vorwort .............................................................................................................................................. VIII Teil I Arzt-Patienten-Verhältnis bei Entscheidungen am Lebensende ................................................ 1 1 Einleitung ........................................................................................................................................ 1 2 Ärztliches Ethos und verdrängter Tod ............................................................................................. 3 2.1 Medizin-ethische Richtlinien................................................................................................... 3 2.2 Thanatos .................................................................................................................................. 7 2.3 Sterben ................................................................................................................................... 13 2.3.1 Soziales Sterben............................................................................................................. 14 2.3.2 Ausgegliedertes Sterben ................................................................................................ 15 2.4 Tod ........................................................................................................................................ 17 2.4.1 Verdrängter Tod ............................................................................................................ 19 2.4.2 Sprachlich ausgegliederter Tod ..................................................................................... 24 3 Arzt-Patienten-Verhältnis .............................................................................................................. 27 3.1 Würde .................................................................................................................................... 28 3.2 Selbstbestimmung ................................................................................................................. 31 3.2.1 Objektives Fachwissen trifft auf subjektives biographisches Wissen ........................... 31 3.2.2 Informed Consent .......................................................................................................... 37 3.2.3 Mutmaßlicher Wille und Notfälle.................................................................................. 39 4 Toddefinierter Leib ........................................................................................................................ 43 4.1 Organ- und Gewebespende.................................................................................................... 44 4.2 Koma ..................................................................................................................................... 52 4.3 Todesdefinitionen .................................................................................................................. 54 4.4 Gefasstes Sterben zu Hause? ................................................................................................. 56 5 Wohin mit dem Leib – was machen mit dem Körper? .................................................................. 61 5.1 Bestattungswesen .................................................................................................................. 61 5.2 Bestattungsgesetze in Deutschland ........................................................................................ 67 5.3 Leichnam ............................................................................................................................... 69 5.3.1 Sektionen, Leichenschau, Obduktion ............................................................................ 71 I 5.3.2 Bestattungsarten ............................................................................................................ 73 5.3.3 Kommerzialisierung des toten menschlichen Körpers? ................................................ 75 5.3.4 „Hier ist der Ort, wo der Tod sich freut, dem Leben zu dienen“ ................................... 78 Teil II: Austritts- und Ausschlussprinzip .......................................................................................... 81 6 Selbsttötung ................................................................................................................................... 81 6.1 Selbstmord und Freitod ......................................................................................................... 82 6.1.1 Suizidratgeber ................................................................................................................ 84 6.1.2 Suizidforen im Internet .................................................................................................. 93 6.2 Ethische Einwände gegen Suizid ........................................................................................... 95 6.2.1 Metaphysischer Einwand gegen Suizide ....................................................................... 95 6.2.2 Sozialethischer Einwand gegen Suizide ........................................................................ 99 6.2.3 Naturrechtlicher Einwand gegen Suizide .................................................................... 103 6.2.4 Medizinisch-psychologischer Einwand gegen Suizide ............................................... 104 6.3 Ahndung der suizidalen Tendenzen (eines Anderen) .......................................................... 108 6.4 Bilanzsuizid ......................................................................................................................... 112 6.5 Suizidprävention um jeden Preis? ....................................................................................... 115 6.6 Beihilfe zum Suizid ............................................................................................................. 118 6.6.1 Ärztliche Assistenz zum Suizid in den Niederlanden ................................................. 119 6.6.2 Beihilfe zum Suizid in der Schweiz ............................................................................ 121 7 Fremdtötungen ............................................................................................................................. 124 7.1 Terminologische Verwirrungen ........................................................................................... 124 7.2 Ethische Einwände gegen Fremdtötungen .......................................................................... 128 7.2.1 Metaphysischer Einwand gegen Fremdtötungen ......................................................... 128 7.2.2 Sozialethischer Einwand gegen Fremdtötungen .......................................................... 130 7.2.3 Naturrechtlicher Einwand gegen Fremdtötungen ........................................................ 131 7.3 Ausnahmen vom absoluten Tötungsverbot ......................................................................... 132 7.3.1 Töten aus Notwehr ...................................................................................................... 132 7.3.2 Todesstrafe .................................................................................................................. 133 7.3.3 Abtreibung ................................................................................................................... 136 7.3.4 Tötung auf Verlangen .................................................................................................. 138 Exkurs: Verzerrte Repräsentation als Argument der Diskussion um Sterbehilfe ................................ 140 II Kritikpunkte an statistischen Erhebungen ....................................................................................... 142 Verzerrungen durch die Fragestellung ........................................................................................ 142 Interpretierte Auswertung ............................................................................................................ 146 Dargestellte Statistik .................................................................................................................... 147 Schwierigkeiten der Statistikbefragung in der Thematik Sterbehilfe .............................................. 149 8 Formen der Sterbehilfe ................................................................................................................ 153 8.1 Grundsätze der ärztlichen Richtlinien zur passiven Sterbehilfe .......................................... 154 8.2 Grundsätze der ärztlichen Richtlinien zur indirekten (aktiven) Sterbehilfe ........................ 156 9 Heraus aus der Grauzone - Die „praktisch wirksame
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