Bundestag on assisted suicide: This should make voluntary death possible

Some issues are too big for party-political conflicts: On Thursday, the Bundestag will decide on two proposals for regulated euthanasia – free from faction constraints. If one of the laws comes into force, suicide will become possible for the seriously ill. This worries critics.

Practically all topics are negotiated and decided in the Bundestag along party and faction lines. If the opinions of individual MPs differ from those of their party, they usually vote with the majority of their group. Only rarely is the so-called parliamentary group requirement explicitly lifted, most recently this was the case, among other things, in the debate about compulsory vaccination or organ donation. On Thursday, parliament must again decide on such a question of conscience: the partial or full legalization of euthanasia.

The MEPs have two cross-party proposals before them, which they vote on without party discipline. One draft law provides for general impunity for assisted suicide, the other for limited criminal liability. The result of the vote is completely open. Both laws have the same number of supporters in parliament, and eight speakers will address each. Both bills could also fail.

How is euthanasia currently regulated?

In 2020, the Federal Constitutional Court overturned a ban on commercial euthanasia that had existed since 2015, as Karlsruhe saw the individual’s right to self-determined dying violated. “Business-like” has nothing to do with money, but means “designed to be repeated”. The groundbreaking judgment opened a door for organized euthanasia – expressly also with regulatory options such as counseling obligations or waiting periods.

Why should a new law come?

Since the judgment of the Karlsruhe judges, euthanasia is not prohibited, but it is also not regulated. The Bundestag as legislator therefore had to work out a regulation, which the members of various interest groups did, regardless of their party affiliation. In the end, enough MPs gathered behind two proposals, which will now be put to the vote.

What does the “limited criminal liability” proposal mean?

In principle, the proposal adheres to criminal liability for “commercial promotion of suicide”. Violations can be punished with imprisonment or fines. According to this, commercial assisted suicide should not be illegal if the person willing to commit suicide is “of legal age and capable of understanding”, has been examined at least twice by a specialist in psychiatry and psychotherapy and has completed at least one open-ended consultation.

In addition, a waiting period should be stipulated: there should be at least three months between the two examination dates. After the final examination, there should still be a “waiting period” of at least two weeks before suicide. The draft also provides for a new criminal law paragraph 217a against “advertising for assisted suicide”. According to this, anyone who offers euthanasia “because of their financial advantage or in a grossly offensive way” should be liable to prosecution.

What does the proposal “general impunity” mean?

If the proposal for limited criminal liability does not get a majority at the first attempt on Thursday, the second concept of impunity will be put to the vote. This provides for fewer restrictions and in principle wants to remove euthanasia from criminal law. The regulation is not intended to evaluate the individual motives for the wish to die, but merely to set up “guard rails” for the path of an adult and reasonable person to suicide. These guard rails also provide guidelines for advice and waiting times – albeit less strict than the other proposal. A precondition for prescribing medication for suicide should generally be advice from a professionally qualified body, in which alternatives to suicide are also discussed. The prescription should then be possible at the earliest three weeks after the consultation – and a maximum of twelve weeks afterwards.

The states should ensure a “sufficient range of counseling centers”. The Federal Council would therefore have to approve the law. In cases of hardship, a doctor should be able to prescribe the funds at his own discretion, even without advice. Such a case of hardship is said to exist when someone is “in an existential state of suffering with persistent symptoms”.

What are the arguments for legalizing euthanasia?

“Access to assisted suicide should be made possible and clearly regulated without turning it into a model. No person is superfluous,” argues SPD politician Lars Castellucci, co-author of the proposal for limited criminal liability. Only his group’s draft law offers effective protection of the free will of all people. Caritas Germany supports the proposal by Castellucci and other members of parliament.

However, this is not enough for the authors of the further proposal. Their law should “prevent an undignified, unreasonable and not voluntary implementation of the wish to die”. Even this liberalization does not go far enough for the German Society for Human Dying. She calls for medication to be made available to adults who are willing to die without mandatory advice. “What is actually important for people is that they can rely on an emergency exit,” President Robert Roßbruch told the editorial network Germany.

What do critics say?

Advice and emergency help for those at risk of suicide and depression

The chairman of the Catholic German Bishops’ Conference, Bishop Georg Bätzing, calls for “maintaining a culture of life-affirmation and mutual care”. Bätzing warns that “an elderly or sick person or a person in an existential crisis” is more likely to have access to assisted euthanasia than good care. The Catholic Church fears that “assisted suicide will prevail as a natural form of ending life”. The Evangelical Church is less absolute in its rejection, but a suicidal wish is “human suffering that – if at all possible – can be averted”.

The Patient Protection Foundation also rejects assisted suicide. It is not about a ban on self-help. However, commercial offers of killing must be prevented and suicide prevention promoted instead. The President of the German Medical Association, Klaus Reinhardt, warns against a “social normalization of suicide”. The psychiatric association DGPPN calls for better suicide prevention instead of easier euthanasia – because often suicidal people are not at all able to “make this decision freely and self-determined” due to a serious mental illness.

Diakonie President Ulrich Lilie also calls for suicide prevention to be given priority. The psychosocial crises behind a wish to die often went undetected. The Paritätischer Gesamtverband rejects both proposals: the proposals do not adequately protect people with suicidal intentions from “private profit interests of individuals”. The authors of both bills took up the criticism and also want to put an application to the vote on Thursday that calls on the federal government to present a concept for a national suicide prevention strategy by January 31, 2024.

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