This hasn’t previously been on NDY’s radar (h/t to Euthanasia Prevention Coalition), but Germany has been grappling with assisted suicide since at least 2005, when a woman disabled by paralysis, Bettina Koch, sought to purchase suicide drugs domestically. She was denied, and then travelled to Switzerland and committed suicide “with the help of the Dignitas euthanasia association.”
In 2012, after a years-long legal battle, her surviving husband received a ruling from the European Court of Human Rights. Although it did not rule broadly on individuals’ rights to assisted suicide, the Court did state that “German courts were negligent in refusing to hear [his wife’s] case,” sending it back to the German courts.
According to DW.com, a German news outlet, the European Court of Human Rights — “decided not to issue a ruling on the right to assisted suicide, saying this duty fell to individual countries. . . . [T]he court said it would not issue a binding ruling on the matter, especially as only four of the 42 comparative states the court examined allowed active assisted suicide. Only three EU member countries – the Netherlands, Belgium and Luxembourg – currently permit active assisted suicide, when someone agrees to a request from the patient to help them end their life. Switzerland is not in the EU.” (As of 2013, there are 28 countries in the EU.)
In a 2015 article, DW.com reported that, “In Germany, assisted suicide is not illegal under criminal law, but the doctors’ own professional code of ethic prohibits it.”
However, in 2015, the German Parliament voted against allowing commercial associations to help people to commit suicide. This criminalized the practice for such groups. At the same time, Parliament rejected other bills to fully legalize assisted suicide. Nevertheless, family members or close associates were reportedly still exempted from punishment in assisted suicide cases.
The after-effects of the 2012 “special case” were again keenly felt in 2017. After subsequent proceedings, on March 2, 2017, DW.com reported that Germany’s federal court ruled that people:
. . . “in extreme circumstances” should have legal access to drugs to end their own lives.
The federal administrative court in Leipzig ruled in favor of “the right for a patient who is suffering and incurably ill to decide how and when their life should end” provided the patient “can freely express their will and act accordingly.”
Reportedly, the purchase of deadly drugs in Germany is forbidden (though not criminal except for commercial associations), but the court found that the right of self-determination meant there should be exceptions for extreme cases “if, because of their intolerable life situation, they had freely and seriously decided to end their lives” and if there were no palliative-medical alternatives.
The “extreme cases” concept based on Mrs. Koch’s case of paralysis is extremely objectionable from a disability perspective, and the absence of a definition of what constitutes an extreme and exceptional case meriting assisted suicide is more than troubling.
In the same year, German Parliament strengthened palliative care to require greater insurance coverage of hospice care for patients in the country.
Then, in January of 2018, the 2017 ruling was called into question by former German Supreme Court judge Udo di Fabio. Also an attorney for Germany’s Federal Institute for Drugs and Medical Devices (BfArM), di Fabio asserted that the state providing drugs to individuals is unconstitutional, as it means the state intervening in some of an individual’s most personal choices. Since 2017, the BfArM had “not only [been] ordered to supply the pill, but also to decide on its own which cases effectively warranted suicide and which didn’t.”
Among other things, the shadow of the Holocaust renders Germany especially sensitive to state intervention in the lives and deaths of its citizens. The BfArM fears the possibility of enacting similar levels of state violence if it continued to be granted the power to give suicide drugs to patients. Although the outcome of di Fabio’s challenge remains to be seen, he has influential people such as Germany’s Federal Health Minister, Hermann Gröthe, on his side; as well as organizations like the German Foundation for Patient Protection.
We hope that these and other actors will continue to stand in opposition to state involvement in assisted suicide in Germany. But frankly, if families are permitted to assist suicide, one wonders if these opponents have ever heard of elder abuse, because from Not Dead Yet’s point of view they’ve certainly left a gaping hole in patient protections.