Active voluntary euthanasia is prohibited in Germany, passive voluntary euthanasia is allowed. Who can you contact when you have the wish to die?

German Basic Law states that every person shall have the right to free development of his personality (Article 2). This also means that you can decide for yourself when to end your life.

This article is directed at severely ill people who see no other option than suicide and their relatives. If you are experiencing a personal crisis and there is hope for a cure, you can contact the German Telefonseelsorge (crisis line). If you are looking for a clinic for your disease, you can find many specialist clinics in Clinic Compass’ Clinic List.

Active Euthanasia

If a husband gives his terminally ill wife medicine that leads to her death in the short-term, he performs active euthanasia. This is prohibited in Germany (§ 216 German Penal Code (StGB)) and can lead to a sentence of imprisonment of up to five years.

In the Netherlands, Belgium and Luxembourg, active euthanasia is allowed, provided that a doctor performs it and abides by certain diligence criteria. However, for German patients it is not an option to travel to one of the Benelux countries. Active euthanasia is performed in a very close relation between the doctor and the patient. The doctor accompanies the patients for many years and doesn’t treat patients he doesn’t know.

Passive Euthanasia

If a husband puts medicine on his terminally ill wife’s nightstand and she takes it herself, he performs passive euthanasia. This is allowed in Germany.

A doctor or a member of a corresponding association can also put the medicine on the patient’s nightstand. This has been established in the decision of the German Federal Constitutional Court of 26 February 2020. Temporarily, this was prohibited for doctors or members of a Euthanasia Association due to so-called “promotion of suicide on business terms”.

Patients who have the wish to die can contact their family doctor so they can provide them with a drug that will cause death. However, Wega Wetzel from the German Society for Dying With Dignity (Deutsche Gesellschaft für Humanes Sterben, DGHS) only sees little chance for success here: “We have the impression that there are still only a few doctors who are open for accompanied suicide although there is an increasing number of doctors obtaining information about this subject.” She recommends patients or relatives to contact one of the euthanasia organisations: the Verein Sterbehilfe or Dignitas Deutschland.

Therapy at the End of Life

There is a third form of accompaniment to death: indirect euthanasia. Let’s assume that the husband took his wife to a palliative ward in a hospital. The doctor can increase the dosage of the painkiller, for example morphine, if the wife suffers from excruciating pain. At that moment, he accepts the risk of shortening her life to reduce her suffering. Thus, it is not a decision for or against death but for the longest possible pain-free time for the wife which can lead to her death.

Living Will – Not only for Emergencies

Let’s assume that the woman never married and lives alone. She had a serious accident and is taken to the hospital where she receives artificial respiration. How would the doctors treat her?

The first question for the doctors is: does the patient have a living will? If she does, it will say whether the patient wants to receive life-prolonging measures such as artificial respiration. If she doesn’t have a living will, the doctors take all possible measures to keep her alive as curing people is their most fundamental stimulus.

Thus, it does make sense to take care of a living will as early as possible. You can contact the German Society for Dying with Dignity: “We have 60 voluntary helpers in different cities all over Germany who advise you individually and free of charge on your living will. You can arrange individual appointments”, says Wetzel. Caritas or Malteser also offer free advice on the living will. If you prefer reading, you can buy the 168-page guidebook “Patientenverfügung” from the German consumer advice centre for 6.99 euros (e-book).

Nobody likes to deal with the subject of death, but if you tackle the issue early, you may save yourself and others unnecessary suffering. The most important aspect however is to communicate with close people about the advantages and disadvantages of euthanasia. It’s your partner, your children or your best friends who accompany you during your last days and who lose a loved one.