The ending I imagined (spoilers)
This is honestly how I thought this movie was going to end. When it instead ended with a syringe/knife/scissors fight, I was disappointed.
The ending I THOUGHT they were going for was a surprise reveal that the nazi had impregnated her with his own semen during her first examination. Remember he even said something about wishing he had children of his own.
I imagined the final conflict was going to be a kind of psychological attack where he revealed to Helen Mirren that she had spent her life with the wrong man, only because she thought they shared a daughter, when in reality she had given birth to the nazi's child.
He could have taunted her about ruining her life with this action and with the lie she was forced to keep, then offered her a choice: finally reveal the whole truth and destroy your daughter's self-concept and her reputation, or keep living the lie by killing him and covering it up.
Then she would kill him and keep the lie intact, essentially sacrificing her own "soul" for her daughter's happiness. This would disprove his cruel assertions about inability to self-sacrifice from earlier in the film.
But instead of all that potential coolness...they stab each other and he dies.