Treatment to the Bitter End: The Big Business of End-Of-Life Care

Germany is the world champion when it comes to surgical procedures – but also when it comes to the occupation of intensive care beds. Operations performed at the end of the patient's life continue to prove especially lucrative. The lamentable tendency for doctors to rely upon financial calculations rather than ethical guidelines when treating patients has particularly severe consequences for those who are wholly dependent on the system: the terminally ill and their relatives. The core issue is the administering of unnecessary therapies at the end of life. Most of these take the form of operations, but is also question of the application of high-tech medical devices to keep terminally ill patients alive – if barely – at great expense, while keeping the cash register ringing for physicians, clinics, and care units. Artificial respiration in an intensive care station costs around €1600 daily. Our healthcare system generates false incentives. In the end, it is only logical that physicians, along with clinics and care stations, which function under enormous cost pressure, deliberately exploit all available resources. In this country, excessive therapies are lucrative, the reduction of suffering penalized. Medical measures are expected to be reasonable and commensurate. But who decides what this means? As a rule, patients and their relations are simply overwhelmed, whole doctors are driven by financial interests – but at the same time genuinely want to help. “Just try telling a patient he can forget about it, a specific cure isn't going to help, that there's nothing more to be done for him,” argue doctors. “Very few patients or relatives want to hear news like that!” And in fact, German patients have become far too accustomed to becoming ever older, to always finding that another method that allows life to be extended, yet another possibility that offers healing and hope. Because of this, they continue to accept pain and excruciating treatments rather than confronting genuine priorities at the end of life: pain relief, quality of life, the right to die with dignity.

This documentary seeks to shed light on the question of which interventions and therapies are sensible at the end of life, and which are pointless. We attempt to provide viewers with an orientation with regard to ethical approaches to the realities of death, and to show when it is clearly a question of profit maximization on the part of clinics, physicians, and care stations. We avoid making one-sided judgments, and instead analyze the healthcare system as a whole in a nuanced way – a system that in many cases offers doctors too little decision-making leeway.

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