Charter for the care of seriously ill and dying people in Germany

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The charter for the care of critically ill and dying people in Germany advocates people who are confronted with dying and death due to a progressive, life-limiting illness. In addition, it is a concern of the charter to anchor dying, death and mourning in social consciousness and to enable all people in Germany to have fair access to dignified accompaniment and care at the end of life according to their individual needs. The five guiding principles of the charter formulate tasks, goals and the need for action in order to improve the care of seriously ill and dying people in Germany. The focus is always on the person affected.

The charter is supported by the German Society for Palliative Medicine (DGP), the German Hospice and Palliative Association (DHPV) and the German Medical Association (BÄK).

development

The development of the charter for the care of critically ill and dying people in Germany

The charter for the care of critically ill and dying people in Germany was created against the background of an international initiative that was agreed as the Budapest Commitments at the 10th Congress of the European Association for Palliative Care (EAPC) in 2007. With the aim of improving the care of seriously ill and dying people, five areas should be focussed and their development promoted: education, further training and further education, research, politics, quality management, general access to the supply of pharmaceuticals.

With Belgium, Denmark, Germany, Greece, Great Britain, Israel, Italy, Lithuania, Croatia, the Netherlands, Norway, Austria, Romania, Sweden, Switzerland, Spain, the Czech Republic and Hungary, 18 countries took up these thoughts. In Germany, the German Society for Palliative Medicine (DGP), the German Hospice and Palliative Association (DHPV) and the German Medical Association (BÄK) are responsible for the national charter process.

In September 2008 ( Charter phase I ), the development of the charter for the care of critically ill and dying people in Germany began as a broad-based consensus process. In August 2010, the charter was adopted by consensus by more than fifty health and socio-political institutions and presented to the public. The current situation in the care of seriously ill and dying people is presented in five guiding principles and on around 25 pages - combined with options for action and a self-commitment for the future.

In the subsequent Charter Phase II (2011–2013) the aim was to disseminate them to the public, to promote their implementation in the form of charter projects and, in the next step, to convert them into a national strategy.

As part of a national strategy ( Charter phase III , 2013–2016), the aim was to implement the guiding principles formulated in the charter in such a way that every person affected, regardless of the underlying illness, personal life situation or the place of care, received high quality palliative and hospice care Receive treatment and support.

By means of a national strategy, the goals formulated in the charter are to be systematically implemented with the involvement of politics at all levels - the federal level, the state level and the municipal level. One of the overarching objectives is to use the national strategy to develop a visible public responsibility of society, politics and all those involved in the health system for the last phase of life and death.

In addition to this, the Federal Ministry of Health set up the “Palliative and Hospice Care in Germany” forum in July 2013.

In October 2016, the recommendations for action were presented to the public as part of a national strategy . These were developed by the round table with its 50 institutions and organizations relevant to health policy in a consensus process. The recommendations for action within the framework of a national strategy have significant potential for further improving hospice and palliative care in Germany.

The recommendations for action are based on the claim to the best possible quality of life and the associated special need for care and support for critically ill and dying people and those close to them. At the same time, they take into account the special challenges that society has to face for individual support and cooperation in the encounter with the phenomena of dying, death and mourning.

The recommendations for the fields of action of the five guiding principles are based on three fundamental goals, the implementation of which is sought in a national strategy:

  1. High-quality hospice and palliative care that is accessible to all those affected and tailored to needs throughout Germany,
  2. financing of high quality hospice and palliative care in hospitals, nursing homes, other forms of living and in the home environment, secured throughout Germany
  3. hospice and palliative care based on a scientific basis and quality assurance for the benefit of those affected.

The presentation of the agreed recommendations for action now concludes the development of the national strategy.

Sponsor

Right from the start, the implementation of the charter process was made possible by the Robert Bosch Foundation and also supported by the German Cancer Aid and the Federal Ministry for Family, Seniors, Women and Youth .

Five guiding principles

Guidelines of the Charter for the Care of Seriously Ill and Dying People in Germany

The aim of the five guiding principles of the charter is to provide access to all people who require hospice palliative care. Tasks, goals and need for action in Germany are formulated. The focus is on the people affected and their needs. The five guiding principles reflect the social challenges, the demands on the care structures, training, further education and training, development prospects and research as well as the international dimension. The full content of the guiding principles can be found in the corresponding links.

Principle 1 - Sociopolitical Challenges - Ethics, Law and Public Communication

Everyone has the right to die under dignified conditions. He must be able to trust that his ideas, desires and values ​​will be respected in the last phase of his life and that decisions will be made with respect for his will. Family and professional help as well as voluntary work support this concern.

Principle 2 - Needs of those affected - Requirements for the care structures

Every seriously ill and dying person has the right to comprehensive medical, nursing, psychosocial and spiritual care and support, which takes into account their individual life situation and hospice-palliative care needs. The relatives and those close to him are to be involved and supported. The care is provided by full-time and voluntary workers as far as possible in the familiar or self-chosen environment. To do this, everyone involved in the supply must work closely together.

Principle 3 - Requirements for basic, advanced and advanced training

Every seriously ill and dying person has the right to appropriate, qualified and, if necessary, multi-professional treatment and support.

Principle 4 - Development Perspectives and Research

Every seriously ill and dying person has the right to be treated and cared for in accordance with the generally recognized state of knowledge. In order to achieve this goal, new knowledge about palliative care is continuously gained from research and practice, made transparent and implemented in everyday care.

Principle 5 - The European and international dimension

Every seriously ill and dying person has the right to have established and recognized international recommendations and standards for palliative care being adequately taken into account for their own good. In this context, a national framework policy is to be aimed for, which is formulated and implemented jointly by all those responsible.

organization

The organization took place on the basis of the following organizational bodies:

  • Steering group - consisting of representatives of the three supporting organizations to steer the overall charter process
  • Round table - as a discussion and consensus body with the main representatives of social and health policy groups
  • Forum "Palliative and Hospice Care in Germany" - led by the Federal Ministry of Health (BMG)
  • Individual working groups - consisting of experts from the various areas to develop the content of the individual subject areas / fields of action
  • Office - as coordinator and primary contact in connection with the working group process for implementing the charter
Organization chart of the charter

round table

The round table , the main consensus and decision-making body, is led by the steering group of the three sponsoring organizations. At regular intervals, the round table provides information on the progress of the individual working groups and decisions on their implementation plans and policy proposals.

In particular, the following organizations and institutions are involved:

Working groups

The experts of the working groups were nominated by the members of the organizations / committees of the charter process (round table, BMG forum and steering group).

The working groups are composed in a variety of ways with regard to the sensitivity and later feasibility of the main topics:

  • political representatives from the federal, state and local governments
  • subject-specific experts
  • Representatives of organizations whose responsibility is to later implement the individual fields of action
  • Representatives of the other subject areas of the Charter (to coordinate and avoid duplication of work or topics)
  • Representatives on the subject of "Children, adolescents and young adults with life-shortening illness"

Obligation

Declaration in support of the charter for the care of critically ill and dying people in Germany

The Charter is not just a project of institutions and organizations: anyone can stand up for the concerns of the Charter. The charter can be used as an opportunity to talk about important concerns of seriously ill and dying people in Germany in the personal and professional environment and to encourage changes.

With their signature, the signatories express their commitment to improving the situation of seriously ill and dying people, their families and those close to them and, on this basis, to advocate the redemption of their rights. In addition, the signatories declare that they support the goals and content of the charter for the care of critically ill and dying people in Germany .

literature

  • German Society for Palliative Medicine e. V., German Hospice and Palliative Association e. V., German Medical Association (Hrsg.): Charter for the care of seriously ill and dying people in Germany. 8th edition, Berlin 2015.
  • Karin Dlubis-Mertens, Friedemann Nauck: Germany has adopted a charter for the care of the critically ill and the dying. In: European Journal of Palliative Care, 2011; 18 (4): 176-178.
  • Karin Dlubis-Mertens, Christof Müller-Busch : Presentation of the charter on September 8, 2010 in Berlin - Everyone has the right to die under dignified conditions. In: Zeitschrift für Palliativmedizin, 2010; 11 (6): 268-270.
  • Felix Grützner: On the way to the national strategy. The charter for the care of seriously ill and dying people in Germany. In: Hospiz-Dialog NRW, 2014 (60): 4–5.

Individual evidence

  1. ↑ Horst Küpper: Oncological and palliative masterclass: Module development for nurses in the Euregio Maas-Rhein . Hamburg 2013.
  2. ↑ Martin W. Schnell: Ethics at the end of life . In: Martin W. Schnell, Christian Schulz (Ed.): Basic knowledge of palliative medicine . Berlin / Heidelberg 2014, pp. 263-269 .
  3. ↑ German Academy of Natural Scientists Leopoldina e. V., National Academy of Sciences (ed.): Palliative care in Germany. Perspectives for practice and research . 2015.
  4. ↑ Lukas Radbruch, Friedemann Nauck, Eberhard Aulbert: Basics of palliative medicine. Definition, development and goals . In: Eberhard Aulbert (Hrsg.): Textbook of Palliative Medicine . Stuttgart 2012, p. 1-136 .
  5. ↑ The Charter - Origin: From an international initiative to implement the Charter in Germany. In: Charta-zur-Betreuung-Sterbender.de. Retrieved April 15, 2016 .
  6. ↑ Karin Dlubis-Mertens: Appendix: Charter for the care of critically ill and dying people in Germany . In: Hubertus Kayser, Karin Kieseritzky, Heiner Melching, Hans-Bernd Sitting (Eds.): Course book Palliative Care. Applied palliative medicine and care . 2nd Edition. Bremen, London, Boston 2013, pp. 43-46 .
  7. ↑ Charter office: Charter for the care of seriously ill and dying people in Germany: The aims of the charter are to be implemented within the framework of a national strategy. (PDF) November 9, 2013, accessed May 2, 2016 .
  8. ↑ Charter for the care of critically ill and dying people. (PDF) press release. In: dgpalliativmedizin.de. June 13, 2012, accessed May 2, 2016 .
  9. ↑ The Charter - Development: From the Charter to a National Strategy. In: Charta-zur-Betreuung-Sterbender.de. Retrieved April 15, 2016 .
  10. ↑ Angelika Westrich: hospice talk. Interviews with Frank-Ulrich Montgomery, Lukas Radbruch, Winfried Hardinghaus . In: The hospice magazine . No. 62 , 2014.
  11. ↑ German Society for Palliative Medicine (Ed.): S3 guideline on palliative medicine for patients with incurable cancer . 2015.
  12. ↑ Annette Widmann-Mauz: "We want to promote the hospice culture and palliative care also in the standard care" . In: Bundes-Hospiz-Anzeiger . No. 5 . der hospiz verlag, 2013, p. 4 .
  13. ↑ Annette Widmann-Mauz: "The strengthening of hospice and palliative care is a major concern of the coalition" . In: Bundes-Hospiz-Anzeiger . No. 3 . der hospiz verlag, 2014, p. 3 .
  14. ↑ Franziska Kopitzsch: From Charter Process to National Strategy . In: care: palliative . No. 25 , 2015, p. 44-45 .
  15. ↑ Bernd Oliver Maier, Thomas Sitte: Basics and supply structures . In: Matthias Thöns, Thomas Sitte (Ed.): Repetitorium Palliativmedizin . Berlin / Heidelberg 2013, pp. 1-12 .
  16. ^ The Charter - Principle 1: Sociopolitical Challenges - Ethics, Law and Public Communication. In: Charta-zur-Betreuung-Sterbender.de. German Society for Palliative Medicine e. V., accessed on August 9, 2018 .
  17. ↑ The Charter - Principle 2: Needs of those affected - Requirements for the care structures. In: Charta-zur-Betreuung-Sterbender.de. German Society for Palliative Medicine e. V., accessed on August 9, 2018 .
  18. ↑ The Charter - Principle 3: Requirements for basic, advanced and advanced training. In: Charta-zur-Betreuung-Sterbender.de. German Society for Palliative Medicine e. V., accessed on August 9, 2018 .
  19. ↑ The Charter - Principle 4: Development Perspectives and Research. In: Charta-zur-Betreuung-Sterbender.de. German Society for Palliative Medicine e. V., accessed on August 9, 2018 .
  20. ↑ The Charter - Principle 5: The European and International Dimension. In: Charta-zur-Betreuung-Sterbender.de. German Society for Palliative Medicine e. V., accessed on August 9, 2018 .
  21. ^ Organization - Charter website. In: www.charta-zur-betreuung-sterbender.de. Retrieved April 15, 2016 .
  22. ↑ Organization - Round Table. In: Charta-zur-Betreuung-Sterbender.de. Retrieved May 3, 2016 .
  23. ^ Organization - Working groups - Charter website. In: www.charta-zur-betreuung-sterbender.de. Retrieved May 3, 2016 .
  24. ^ Franziska Kopitzsch, Winfried Hardinghaus: Preparatory Working Group 6: "Children, adolescents and young adults with life-shortening illness" . In: the hospice magazine . No. 4 . der hospiz verlag, 2015, p. 6-8 .
  25. ↑ Franziska Kopitzsch: Talk about doing good! In: Bundes-Hospiz-Anzeiger . No. 12 . der hospiz verlag, 2014, p. 1-4 .
  26. ↑ The Charter - Charter website. In: www.charta-zur-betreuung-sterbender.de. Retrieved April 25, 2016 .