Withdrawal and withholding of medical treatment: Czech medical law at the crossroads.

The making of an end of life decision represents worldwide one of the most difficult issues that physicians can be confronted with --not only should it be regarded as consisting of medical and legal aspects, but ethics and moral values are present as well. Furthermore, it shall not be supposed that the economic parameter is negligible, unfortunately even to the contrary. The fact that the decision is often made by physicians under pressure caused by a system of limited resources (and therefore it can not avoid being distorted) must be kept in mind. At any rate , according to Czech law under which neither assisted suicide nor euthanasia is allowed, the legality and legitimacy of withdrawal and withholding of medical treatment is based on the argument of informed consent of the patient, advanced directives and the standard of lege artis treatment. These also shall be pleaded as defences in eventual criminal proceedings.