Is it illegal to kill yourself?
Right to suicide and euthanasiaSelf-determination until death
"Sure, I could go to Switzerland. It would cost me a lot, a few thousand, and not least an effort, because I would have to be willing to put myself in the hands of an organization, get involved with professional euthanasia, and - the worst idea - to get me an appointment. The appointment would be on my calendar. It would come closer, I could count the days, and at some point it would be clear: next week, in three days, tomorrow, and if tomorrow weren't a good day to die ? "
An excerpt from the film "Hin und weg" by Christian Zübert. It's about Hannes. He has ALS, a neurodegenerative, progressive disease that gradually leads to complete paralysis of all muscles and is always fatal. Hannes makes an appointment at the end and has the lethal injection. This active euthanasia, allowed by our neighbors in Holland and Belgium, is forbidden in Germany. But since February we have had the highest judicial right to help with suicide. In the judgment it says:
"The decision to commit suicide affects fundamental questions of human existence and affects human identity and individuality like no other decision. (...) The right to self-determined death is not restricted to situations defined by others, such as severe or incurable illnesses or certain phases of life and illness every phase of human existence. "
Self-determination instead of "fate" or "divine will"
The end of life is seldom beautiful. But it is inevitable. Fate or divine will earlier generations called dying and death. They were mostly accepted as they came. But our plural, modern society allows and even expects everyone to take their fate into their own hands - in life as well as in death. Lukas Radbruch, Head of Palliative Medicine at two clinics in Bonn and President of the German Society for Palliative Medicine:
"How far-reaching and what kind of statement that makes for our society, I still find a bit terrifying."
Volker Gerhardt teaches practical philosophy with a focus on ethics and cultural philosophy at the Humboldt University of Berlin:
"I was less surprised by the breadth of the judgment than I was pleased by the decisiveness with which this principle of self-determination was insisted."
Gerhardt was a member of the German Ethics Council for many years, belonged to the Chamber for Bioethical Issues of the Evangelical Church and has written a standard work on "Self-determination" as a principle of individuality:
"It is a historical process which, very early in the cultures of the ancient Orient and antiquity, led to individualization being a very essential element of social organization and the establishment of individual life. We can only create a legal order for a society then expect when we assume that the individual's independence is actually the regulative that one can rely on. "
(imago images / Martin Wagner) Judgment in Karlsruhe - ban on "commercial euthanasia" is unconstitutional
The Federal Constitutional Court has overturned the current regulation on euthanasia. It is precisely about the ban on the "commercial promotion of suicide". Seriously ill patients, euthanasia associations and doctors had complained against it.
"Morality of the categorical imperative"
According to the philosopher, a liberal society presupposes the self-responsible subject. It almost belongs to the vital function of an organized society. A community based on the division of labor is based on the prerequisite of the individual's commitment to the general public. That means with all consequence: I decide for myself. And that has less to do with secularization, i.e. the modern departure from a world of gods, than with the process of individualization, says Volker Gerhardt:
"In this respect, this is an old principle, which in antiquity was defined by the concept of autonomy and the self-sufficiency of the individual. It then only came into effect in this clarity under the concept of self-determination in the 18th century a morality that almost everyone, including church representatives, almost invariably invokes in the biopolitical debate, namely the morality of the categorical imperative. "
"Act only according to the maxim by which you can at the same time want it to become a general law." - Immanuel Kant, Foundation for the Metaphysics of Morals, 1785. Volker Gerhardt:
"I have to understand it myself, then I can also take into account humanity in my person with the principle of my action. That is the basic principle. And there you already see in the formulation how closely individuality, self-determination and the perspective on everyone's life belong together. "
Sovereign self-determination becomes difficult when one is dependent on outside help (dpa / Klaus Rose)
To die so as not to be a burden to others?
So much for the theory. The constitutional judges decided on the basis of the right of personality, which proceeds from the theoretical ideal of the sovereign, enlightened individual who has every freedom to choose from. The reality is different. Each of us is caught in a variety of different conditions and dependencies, and they are not all in our hands. They are also different from things as specific as health, money, status, family, friends, and education. All of this can and will influence our decisions at the end of life. It makes a difference whether I can stay in a retirement home or in a public nursing home. Palliative research has asked residents in nursing homes how they feel and what they want, says Lukas Radbruch. Many declared:
"They don't want to live anymore because they don't want to be a burden to others. The idea that the dependence on other people who care for you is something really bad, that is a very negative characteristic of our society. It is for all a flaw. You don't want to be a burden to anyone. Our society has such an image of being active, being independent, being independent, age is also great, but only good if you can experience it as an active, self-determined person absolutely that nowhere in your life you are as free as you demand for the end of your life. "
(picture alliance / dpa / Jm Niester) Debate about suicide assistance - soon euthanasia in church institutions?
In the churches some seem to move away from the previous "no" to euthanasia. Some theologians and church officials can imagine that patients in church institutions would have access to lethal substances should such a law be passed.
"Emergency exit" for the desperate, seriously ill
The seriously ill people who complained to the Constitutional Court, however, were not primarily concerned with their dependency on care. Above all, they did not want to have to go through their ordeal to the end. One of them is Harald Meier. At the age of 27 he developed multiple sclerosis. Since 2015 he has been able to speak, move his facial muscles, breathe and swallow, but his whole body is paralyzed. If everything stayed that way, he would like to go on living, he said in a film by Erika Fehse on Westdeutscher Rundfunk in February:
"It goes on, what's next? Can I no longer swallow? Can I eat normally? Then there is despair. Then there is a great need that I need an emergency exit."
Assistance to suicide was never expressly forbidden. Until 2015, doctors could also assist their patients if they were freely responsible and mentally healthy. Then, five years ago, Paragraph 217 - the prohibition of commercial suicide assistance - was passed by the Bundestag. And unsettled doctors and patients.
"Anyone who, with the intention of promoting the suicide of another, gives him the opportunity to do so on a business basis, procures or mediates, is punished with imprisonment of up to three years or a fine."
Constitutional Court opens the way further than expected
In order to be able to stand by patients like Harald Meier in the end, the palliative medicine specialist Benedikt Matenaer from Bocholt sued the constitutional court:
"There was a concern that people like me, who on rare occasions would be willing to assist with suicide, would make themselves liable to prosecution. That was the motivation to say it can't be. I'm always someone who tries to to keep people in life, but I would like to be able to enter into such a conversation openly and then also be able to accompany such a path from time to time. "
Like most of the six plaintiffs, the doctor wanted an emergency exit for a few individual cases. For this, paragraph 217 should fall. But the Constitutional Court went a big step further. The emergency exit is now a broad portal for self-determined death in "every phase of human existence".
"This is a systematic problem," explains Reiner Anselm, professor of systematic theology:
"If you don't want to classify some stages of human life, you say that some are more valuable than the others, then you actually have no way of making a difference anywhere. The court then decided to say: Then we don't make a difference , that applies to all stages of life, no matter how old, how sick or whatever. "
The telephone counseling is a contact for people who have thoughts of suicide (picture alliance / dpa / Tobias Hase)
Theological ban on suicide cannot apply to everyone
What right could one forbid a person to put an end to his or her life? The argument that suffering is part of life? With the holiness of life as a gift from God? This could be significant as an individual belief, but not apply as a commandment for all people, says the Protestant theologian Reiner Anselm:
"I would not say, as so many now see, that it robs religion. You have to think about it, that has to apply to all people in the community. I can understand that you cannot make a particular conviction the basis for the community. That doesn't prevent anyone from saying, based on their individual convictions, no, I don't want that. "
The verdict goes far too far for the palliative care specialist Lukas Radbruch. Self-determination has always been a model of palliative medicine, explains the President of the Palliative Society. There are many ways to prevent severe suffering at the end of life:
"Most people with such chronic illnesses have life-sustaining things like blood washing, ventilation or artificial nutrition. And with all of these they have a right to have it stopped. We recently also made a position paper on not eating and drinking. If there are symptoms, I can shield the patient from them. It all works. "
(Joshua Earle / Unsplash) Georg Diez vs. Wolfgang Beck - Is suicide an expression of self-determination?
In its suicide decision, the Federal Constitutional Court placed the protection of autonomy above that of life. The author Georg Diez says that liberating those willing to die from constraints imposed by church and state. The theologian Wolfgang Beck contradicts: This self-determination is a burden, not freedom.
"Killing on demand" remains inadmissible in Germany
"I would like to end it humanely, that would be with such a drug. And no torture, shortness of breath - just fall asleep and never wake up."
Harald Meier wishes for a gentle death in the WDR portrait. Like all of us, I suppose. According to current surveys, over 70 percent of all German citizens want euthanasia, i.e. switching off life-sustaining measures and assisted suicide. 67 percent are in favor of active euthanasia, i.e. killing on demand. The latter, however, has clearly ruled out the constitutional judgment. Everyone has to swallow the deadly drug themselves.
But how stable is a wish to kill anyway? American studies, in particular, showed that patient requests issued in writing at healthy times are often changed again in the face of a serious illness and at the end of life. Lukas Radbruch:
"In my experience I experience that this is very fluctuating. That patients really say this classic sentence, they would put a dog to sleep, why don't they do that for me? And in the same conversation they also express hope and would like to continue therapy. So it's never black and white, it's always gray. "
Precisely because nobody can know exactly, one's own will is the only yardstick, believes the philosopher Volker Gerhardt:
"As a rule, he probably doesn't know exactly either. But at least it's his will and you should let him make this final decision. I would like that if it were implemented."
Roger Kusch, CEO of the Euthanasia Germany Association on the day the judgment was pronounced in the Federal Constitutional Court (dpa / Uli Deck)
Commercial suicide assistance is generally permitted again
The 2015 ban on offering suicide assistance as a service hindered this free will, argued the constitutional judges. Because without the business-like offers of suicide assistance, the patients are dependent on the individual willingness of the individual doctors. So far, however, only a few of them are ready and cannot be forced in the future either. However, the pain therapist Benedikt Matenaer thinks that this is solely a task for the trusting and grown relationship between doctor and patient and does not belong in the hands of commercial organizations:
"I do think that there are situations in which it can also be a medical task to help people commit suicide. This ruling allows euthanasia associations to resume their work. Legislators are already required to regulate this work. "
The euthanasia associations reported back immediately after the judgment, with an advice portal under the clear name: Ende.PUNKT. But the legislator has the last word. The constitutional judges tossed him the ball to trap free will where it could possibly come under social pressure.
Do not establish suicide as the normal end of life
The highest judges find "understandable" concerns that "business-like assisted suicide can lead to a normalization of assisted suicide in society (and that assisted suicide could establish itself as a normal form of ending life, especially for old and sick people”. "
Health Minister Jens Spahn is therefore currently collecting proposals for a "legislative protection concept" to regulate suicide assistance. Lukas Radbruch:
"I have to say that the idea that this would create practically state-certified euthanasia organizations also fills me with horror - and I fear the legislature too."
The death of footballer Robert Enke in 2009 sparked a social discussion about depression and the risk of suicide (imago images / Joachim Sielski)
Around 10,000 people die of suicide every year in Germany, and well over 100,000 suicide attempts are estimated in the same period, explains the Society of Specialists in Mental Health. According to current suicide research, 90 percent of all suicides are directly related to depression and other mental illnesses. In the name of self-determination, the constitutional judges have opened the gate wide for all those who are weary of life: the right to euthanasia applies "in every phase of human existence." So that this judgment does not become an invitation to die gently, each of us is asked to invite us into life, says the philosopher of self-determination, Volker Gerhardt.
"Self-determination does not exclude participation in the fate of the other at all. On the contrary. Especially under the conditions of the constitutional judgment, it is an important point that the individual responsibility of fellow human beings is now much more challenged Desperation in the short term or from an erroneous assessment of the situation or in the expectation that the treatment is unbearable, to show him that it is worth living on. "
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