The term living will describes a person's declaration of intention, which the person expresses for the case that his or her health does not allow him or her to agree to or reject certain medical measures that concern him or her. These living wills are of high significance when it comes to the self-determination of a patient because varying moral concepts can cause the opinions of those involved in a situation of treatment to be opposed to one another. Especially in cases where patients by means of living wills reject for themselves life-prolonging measures or where they, for the case of their own inability to make decisions, which might set in at a later point in time, even demand to be let die or to receive active euthanasia, hence making necessary the involvement of a third party, situations arise in which a medically indicated measure does not comply with the will of the patient. There has to be a definite rule which determines the weight of the patients will.

In the debate concerning the legal status and the bindingness of living wills, several heterogenous opinions were expressed. Amongst others, the working group "Patients' autonomy at the end of life", which was established by the Federal Ministry of Justice on 10 June 2004, presented its final report in which it demands that the wishes expressed in living wills - if they apply to the concrete situation - shall be binding even "if the disease has not yet become fatal" (unofficial translation).

To the contrary, the Inquiry Commission Ethics and Justice of modern medicine of the German Bundestag (15th legislative period) published an intermediate report on 13 September 2004. In this report, the Commission advocates that a renunciation or termination of a medically initiated or medically proposed life-sustaining measure shall be put into action only "if the underlying disease is irreversible and will, according to a medical evaluation, lead to death despite of medical treatment". (unofficial translation).

Only recently has the legal status and the bindingness of living wills been legally regulated in the Parliament. On 18 June 2009, the German Bundestag decided on the law for changing the guardianship law, which had been proposed by, amongst others, the Members of the Bundestag Joachim Stünker (SPD) and Michael Kauch (FDP).

It is the goal of this draft "to establish legal security for all persons concerned by means of legally regulating the living will" (unofficial translation) and to strengthen the respect for the maxim of self-determination. The living will, whose condition for validity is the written form or a comparable form such as a video-recording, is being fixed in the guardianship law.

The will of the patient settled in the living will has to be observed independently from the nature and the stadium of the disease. Its neglect is considered a criminal assault. If, in a case of a particularly severe decision of a caretaker or an authorized representative, it is being suspected that he or she might not act according to the will of the patient, this decision needs to be approved by the guardianship court. The court also has to be contacted in cases where "physician and the caretaker have different opinions as to which decision is in accordance with the will of the patient" (unofficial translation) or in cases where "there is a justified risk that the person being taken care of dies as a result of the measure or suffers a severe and longer lasting damage to his or her health" (unofficial translation).
Such a measure that has not been approved can be carried out only if a suspension is linked with a risk for the person being taken care of.

Neither is it unconditionally essential to have a counselling interview with the physician before the living will is being written, nor does the living will have to be affirmed anew at regular intervals by means of signature and date. The decision to write or not to write a living will is up to every human being. Even if a living will would, from the view of nursing staff or relatives, disburden their subsequent action, no one shall be pressured or forced to write a living will. Statements of will "which are aimed at the prohibited killing upon request remain invalid" (unofficial translation).

As an alternative to the Stünker-draft, the Members of the Bundestag Hubert Hüppe, Beatrix Philipp, Prof. Dr. Norbert Lammert (all members of the Christian Democratic Union/Christian Social Union (CDU/CSU)) as well as further Members of the Bundestag submitted a petition in which they opposed the "legal overregulation of the living will" (unofficial translation).

The wish to write a living will for the case of one's personal incapability to give consent is, the Members of the Bundestag state, understandable; future diseases and sufferings are, however, unpredictable. Although living wills are in practice given attention if the wishes expressed in the living will are in accordance with the respective situation, there will always be cases in which living wills cannot be applied and are hence not binding. According to this draft, the current legal situation is entirely sufficient, meaning that "legal regulations going beyond the current legal situation are neither necessarily nor convincingly possible" (unofficial translation). This draft could, however, not win through.

The draft of a group surrounding the Member of the Bundestag Wolfgang Bosbach (Christian Democratic Union/Christian Social Union (CDU/CSU)) did not have majority appeal either. This draft envisioned that a statement of wishes in a living will shall be "preceded by a comprehensive medical and legal consultancy, be documented and authenticated with the living will by a solicitor and shall be no older than five years or confirmed by a new medical consultation" (unofficial translation). In cases of curable diseases, the physician is not obliged to attend to the wishes expressed in a living will that has been written without medical consultation. Contents not aimed at a termination of treatment are nonetheless, binding.