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A personal exploration of the German hospice system

Hospice of the Visiting Nurse Association of Greater Philadelphia, Philadelphia, Pennsylvania

While on vacation in Germany, I explored the German hospice system and its differences from that in the United States.

I conducted an informal survey asking 10 individuals who were not associated with hospice work, about end-of-life issues. Knowledge of the hospice movement and of advance directives was found to be quite low.

Through contact with German hospice associations, I learned that the modern German hospice movement was inspired by the British example. After a difficult beginning, the German hospice system is growing steadily. Professional providers of end-of-life care are paid according to the traditional fee-for-service system. As suggested by the World Health Organization, pain management is provided according to the three-step analgesic ladder. Physician-assisted suicide is illegal as it is in the United States. A federal self-determination law has not yet been enacted.

Overall, the German hospice system has many similarities and a few interesting dissimilarities with that in the United States.

American Journal of Hospice and Palliative Medicine®, Vol. 13, No. 4, 32-37 (1996)
DOI: 10.1177/104990919601300407


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