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German court overturns ban on assisted suicide

Germany’s highest court announced Wednesday that it has ruled a 2015 law banning assisted suicide when being conducted on a 'business basis' is unconstitutional.
Germany’s highest court announced Wednesday that it has ruled a 2015 law banning assisted suicide when being conducted on a 'business basis' is unconstitutional.Uli Deck/DPA/Associated Press/dpa via AP

BERLIN — Germany’s highest court Wednesday overturned a ban on organized medically assisted suicide, allowing terminally and gravely ill patients to seek help ending their lives without leaving the country.

The ruling came after a longrunning discussion about the role of doctors and caregivers in end-of-life decisions, one that has special resonance in a country where Nazi doctors killed hundreds of thousands during World War II.

A group of doctors, patients, and proponents had sued to change the criminal law banning organized assisted suicide, arguing that the measure infringed on their constitutional right to make decisions about their own lives.

The case centered on wording in the law that forbade professionally assisted suicide and made it punishable by a fine or up to three years in jail. The law allowed assisted suicides for “altruistic motives” but forbade people from offering it to someone else “on business terms.”

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“The rule is not compatible with the basic law and thus void,” Judge Andreas Vosskuhle, the president of the eight-member Federal Constitutional Court, said Wednesday. The court found that the right to die “includes the freedom to take one’s life and to rely on the voluntary help of another person.”

The court’s decision comes more than four years after the German parliament moved away from many of its European neighbors by voting to ban organized assisted suicide.

With the ruling Wednesday, Germany will once more allow people to help those too ill to end their lives, even if they do so in an organized fashion, as medical practitioners and end-of-life volunteer associations aim to do.

But the ruling was not welcomed by all. Hermann Gröhe, a former health minister who helped create the original ban, told reporters that he believed the decision would pave the way toward the “normalization of suicide as a treatment option.”

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Beatrix von Storch, a member of the far-right Alternative for Germany party, said the decision would have wide-ranging consequences and would create “a cult of death.”

It was hard to determine how many patients would make use of the ruling. While more than 9,000 Germans killed themselves in 2017, Germany does not keep track of those who had been gravely ill before. In the past, many sick Germans wishing to end their lives would travel to Switzerland, where the practice is legal. Dignitas, an assisted-dying association in Switzerland, counted 3,225 German members last year, the nationality most represented in the association.

The ruling gives doctors wider powers not just for rare end-of-life decisions but also in palliative care, said Dr. Matthias Thöns, one of the physicians whose complaint took the case to the constitutional court.

Thöns, who treats patients in their homes, explained that under the old ban, he had to worry about how much pain medication he would leave patients, lest he become criminally liable in the event of a purposeful overdose.

“It is a good judgment for people in desperate situations,” Thöns said in a telephone interview from Karlsruhe, Germany, where he had traveled to hear the judgment.

And although he welcomed the decision, Thöns warned that the practice needed to be tightly regulated.

The law that was introduced to stop organized assisted suicide passed parliament with a solid majority in 2015. But the constitutional court had already weakened the law when it ruled in 2017 that patients in extremely exceptional circumstances could not be barred from access to lethal drugs.

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The German government said it would examine the court’s ruling before deciding how to proceed, a spokesman said Wednesday.

The subject is especially contentious in Germany because of the Nazi practice of using euthanasia as public policy to kill hundreds of thousands of sick and disabled people.

“The discussion will start all over again” Thöns said. “But this time, with the guidelines of the constitutional court.”