Debate about suicide assistance: Experts call for new standards in Munich!

Debate about suicide assistance: Experts call for new standards in Munich!

A sensitive and highly complicated topic is currently being discussed in Munich: suicide assistance. Wolfgang Putz, an experienced lawyer and medical law expert, recently filed a constitutional complaint that could have a significant impact on current case law. The decision of the Federal Constitutional Court in 2020, which declared the ban on commercial suicide assistance unconstitutional, has redefined the framework for ongoing discussions. Putz appeals to the medical profession to urgently develop standards for determining the voluntary responsibility of a suicide wish in order to create more legal certainty. “Neither the legislature nor the courts can do this adequately,” said Putz. This request is particularly important because the need for clear guidelines in practice is becoming increasingly clear, as Putz contradicts the common opinion that the medical profession and the judiciary are competent enough to clarify such questions.

This issue raises several complex questions. Prof. Thomas Pollmächer from the Ingolstadt Clinic addresses the psychological challenges that arise when assessing suicide wishes. Pollmächer emphasizes that the free formation of will cannot simply be based on the comprehensibility of a suicide wish and that mental illnesses do not necessarily exclude the ability to form a well-founded will.

A supportive approach

Another important aspect was addressed by Prof. Georg Marckmann from the LMU Munich. He sees the need to switch from a strict protection concept to a support concept for people who wish to die. Marckmann demands that the ability to self-determine should not only be checked, but that individual solution approaches must also be discussed with the patients as part of “shared decision making”.

A current report from the Health Department of the City of Munich and the LMU Institute for Forensic Medicine shows that there was an increase in assisted suicide between 2020 and 2023. Prof. Sabine Gleich reported that a total of 77 cases were registered during this time, accompanied by a small number of doctors offering suicide assistance through euthanasia organizations. This raises questions about the existing protection concepts, particularly for vulnerable groups such as people who have already attempted suicide.

Legal situation and ethical considerations

The legal framework in Germany is clear: suicide and assisted suicide are not punishable, as the German Patient Protection Foundation emphasizes. There is the right to self-determined death and the right of the individual to self-determination. But the question arises as to society's duty of care. The need for legal regulation of assisted suicide is becoming increasingly present in the public discussion.

The situation looks different in other countries. While in countries like Switzerland assisted suicide is only punishable if the motive is selfish, in the Netherlands, Belgium and Luxembourg medical assisted suicide is exempt from punishment under certain conditions. In the USA, especially in Oregon and Washington, assisted suicide is even permitted by law. These different regulations abroad repeatedly lead to comparisons and discussions within Germany.

In addition, experts such as Prof. Michael von Bergwelt from the LMU Clinic urge caution. Despite encouraging developments in oncology that offer patients better quality of life and duration, an increased presence of suicide assistance on social media could lead to frivolous suicide wishes. The question here is how society and, above all, medical professionals should react to such developments in order to offer patients the most adequate support possible in their most difficult hour.

The debate surrounding assisted suicide remains exciting and requires a high degree of sensitivity and responsibility from everyone involved. The challenges are diverse and the social and legal framework must be constantly evaluated and adjusted.