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Euthanasia bans on the brink?

Euthanasia bans on the brink?

The constitutional court will decide on Wednesday whether the strict conditions regarding euthanasia will be relaxed in Germany. This is the hope of many terminally ill patients who want to end their suffering independently through suicide.

“If I can no longer stand the pain, I would like to be allowed to go,” asks Melanie S. medical doctor Lukas Radbruch at the Bonn-Venusberg University Hospital. The 63-year-old suffers from lung cancer at an advanced stage. What is particularly troubling for you is the fear of suddenly not being able to swallow and then simply suffocating. She does not want to experience that with full consciousness. Without saying it, Melanie thinks about the possibilities of medically assisted suicide.

Such euthanasia was previously prohibited by Section 217 of the German Criminal Code. The Bundestag created this law in December 2015 to prohibit associations or individuals from “doing business with death”. The law says: “Anyone who intends to promote, commit to, or mediate another’s suicide on a business basis is punished with imprisonment of up to three years or a fine.” Lawyers disputed vigorously about the term “businesslike”. Because “business-like” and therefore punishable should be the “repeated advice” on euthanasia. Even a reference to a “fasting to death” by refraining from food could have been punishable.

Journey to die

The consequences were drastic: Not only did the assistants to the public who appeared until 2015 withdrawn with their offers, many doctors or staff in German hospices no longer dared to hold counseling talks on the subject of end-of-life care. The only thing left for those who were terminally ill to die was a trip to Switzerland or the Netherlands for appropriate offers. Active euthanasia by third parties is even allowed there.

Germany Bonn euthanasia patient Melanie S. (DW / W. Dick)Melanie S. in conversation with her daughter on the palliative care unit

Anyone who could not undertake these trips due to lack of strength or money was left to ask a family member to help with the suicide. Family members who agreed to do so remained unpunished. But which terminally ill would want to burden his relatives with such a request?

A disgrace, felt many affected and left to their own devices. Patients and doctors filed suit before the Federal Constitutional Court. Munich medical lawyer Wolfgang Putz speaks to DW about unsustainable conditions that urgently need to be decided again: “The influence of the two large churches in Germany on political decision-makers is still very great, even though we are supposed to be a secular state”.

Germany euthanasia lawyer Wolfgang Putz (picture-alliance / dpa / U. Deck)Medical lawyer Wolfgang Putz advocates liberalization of euthanasia

The Evangelical and Catholic Church are against any form of active euthanasia. It is good that the Federal Constitutional Court, as the highest legal authority in Germany, could now regulate the self-determination of individuals guaranteed in the Basic Law at the end of life, said Putz.

Poorly known possibilities of palliative medicine

The medical doctor Lukas Radbruch, addressed by Melanie S., listens to her intensively for a long time. A lot of understanding is crucial now, Radbruch knows, who is also president of the German Society for Palliative Medicine. For medicine that wants to relieve pain when healing is no longer possible. He has found that the question of euthanasia is often a cry for help, a hope “for an emergency exit”. If he could then make an offer to help with pain-relieving “sedation”, it would be accepted in most cases. 

Germany Bonn euthanasia Lukas Radbruch (DW / W. Dick)As a palliative care doctor, Lukas Radbruch can take the pain away from patients

“If the current ruling by the Federal Constitutional Court, the possible abolition of paragraph 217, gives us new motivation for euthanasia patients, it means a dangerous development of our society,” says Radbruch. He fears that many terminally ill people would increasingly say that they don’t want to be a burden to anyone. However, it should not be possible to build up a pressure situation. And the inhibitions to end life yourself should not be reduced under any circumstances.  

The new euthanasia scheme

“Paragraph 217 is not compatible with the Basic Law,” the presiding judge of the 2nd Senate at the Federal Constitutional Court could explain this Wednesday. The likelihood that this will happen is estimated by almost everyone involved in the process hearing in the run-up to the judgment to be very high. If paragraph 217 tilts, euthanasia would be possible within the old borders as before. Doctors could therefore provide information about euthanasia and provide passive euthanasia, i.e. they could not administer a lethal medication, but could make it available.

Germany trial for the right to suicide - Harald Mayer (picture-alliance / dpa / R. Pfeil)Harald Mayer insists on his right to suicide

Harald Mayer also builds on this. He has multiple sclerosis. His muscles have been dwindling for years. In the meantime, he can hardly move. It takes seven to eight shiftwork assistants to dress and undress the 49-year-old former firefighter at the U.S. Air Base in Ramstein, hand him food, or help him relieve himself. Mayer finds this point particularly humiliating. “With full mental awareness, my body becomes an increasingly tight prison,” says Mayer of his situation. He finds this loss of autonomy unbearable. Almost every day he has little more than to stare at the ceiling. He now hopes for salvation, for someone who offers him euthanasia, because he himself says: “I don’t want this anymore.

Minister of Health prevents the delivery of lethal medication

In addition, due to a decision of the Federal Constitutional Court against paragraph 217, another process to amend the Narcotics Act in the sense of Harald Mayer could follow.

Because Mayer had applied to the Federal Institute for Drugs and Medical Devices (BfArM) in Bonn as a seriously ill person to apply for sodium pentobarbital (NaP), which is considered to be relatively safe and painless and is used in euthanasia in Switzerland.

Although the administrative court held in a ruling that the seriously ill are entitled to this barbiturate, Federal Health Minister Jens Spahn instructed the federal authority not to grant an application for lethal medication. In doing so, he defies current jurisprudence, critics say.

Germany Bonn euthanasia Robert Roßbruch (DW / W. Dick)Robert Roßbruch, Vice President of the German Society for Human Dying

Professor Robert Roßbruch, Vice President of the German Society for Human Dying (DGHS), represents Mayer and already announces if Mayer’s suicide continues to be unsuccessful before the European Court of Human Rights. “In my legal opinion, paragraph 217 clearly violates the European Convention on Human Rights.”    

Medieval thinking?

One of Germany’s best-known assistants to death, politicians and those responsible in the health sector, accused the way of thinking as before the Enlightenment. “How can people who have never suffered from a serious illness venture to judge whether life still seems worth living or not?” Uwe-Christian Arnold asked again and again. “If the terminally ill, but still mentally fit and autonomously thinking, wish to die, then they should be given an opportunity to shape their end themselves in a dignified process.”  

Arnold, Berlin specialist in urology, has been actively involved in this since the mid-1990s. He risked losing his medical license because he violated professional oath with his euthanasia, always promoting life instead of ending it.

Death assistant Uwe Christian Arnold (DW / W. Dick)Uwe-Christian Arnold keeps an eye on the medication

However, Arnold won every lawsuit against him and, according to his own statements, accompanied over 100 people nationwide after intensive research and discussions on the mental state of “his patients” in the death they desired.

This included Ingrid Sander, whose son once said about Arnold that he had been his mother’s best life insurance for a long time. Arnold’s promise alone to help her die if the pain of her polio, which she had acquired at the age of five, became too unbearable, had been very reassuring to her.

Uwe Christian Arnold, euthanasia worker and patient Ingrid Sander (DW / W. Dick)Assisted by death, Uwe-Christian Arnold, accompanied Ingrid S. for many years until she committed suicide

Ingrid fought bravely until the very end. Then the complaints became so severe that she feared that she would no longer be able to take a given death medication, as passive euthanasia had permitted until 2015. Finally, she asked her son to set up a mix of drugs. Months before they had talked a lot about it and had had enough time to say goodbye. A camera team accompanied the two in the last few minutes. Ingrid asked for a cheerful piece of Viennese classical music, hugged her son for a long time. Then it fell silent. The next day he says: “It was very difficult for me to let my mother go. But she shouldn’t suffer. It was her wish to go.” And: “My mother looked very happy when she finally fell asleep peacefully.” 

Arnold, euthanasia

He was one of the complainants against paragraph 217. He was supposed to make a five-minute statement before the Federal Constitutional Court in April 2019 and report on his professional practice. President of the Federal Constitutional Court, Andreas Voßkuhle, personally advocated Arnold’s testimony and was particularly interested in finding out in which life situation patients express suicidal wishes and how they are dealt with. But that never happened. Arnold suffered from bone cancer and died before the trial. However, Arnold’s lawyer was allowed to read a statement. Arnold had never expected the Federal Constitutional Court to really overturn paragraph 217. If the judgment now leads to the liberalization of euthanasia, it would be in the interests of the deceased.

Deutsche Welle reports reluctantly on the subject of suicide, as there are indications that some forms of reporting can lead to counterfeiting reactions. If you have thoughts of suicide yourself or are in an emotional emergency, do not hesitate to seek help. For help in your country, go to https://www.befrienders.org

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