This week, Germany’s Federal Constitutional Court heard a number of complaints against the ban filed by seriously ill people, assisted suicide caregivers, palliative physicians and other doctors – with a verdict expected to be reached at the Karlsruhe court in a few months at the earliest.

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Since December 2015, the new paragraph 217 of the German penal code forbids the “commercial promotion of suicide”. Violations can result in up to three years imprisonment or a fine. Among the Karlsruhe plaintiffs are professional suicide assistants such as the Hamburg ex-Justice Senator Roger Kusch with his non-profit Sterbehilfe Deutschland (Assisted Suicide Germany).

Several European countries, such as neighbouring Switzerland, legally support physician assisted suicide, stressing that it is a humane way of letting terminally ill people end their suffering.

Yet the topic is an especially touchy subject in Germany, which has a rapidly aging population – many who feel physician assisted suicide puts them in conflict with conservative religious values – and Germany’s history of euthanasia during World War II.

Yet physician-assisted suicide cannot be labelled “euthanasia” as it is the patient who makes the decision following a discussion with a doctor, including if there is hope that their current situation can improve, a spokesperson from the non-profit Dignitas in Switzerland told The Local.

If a person does decide upon a physician's assistance, they can die in dignified manner rather than turning to “terrible suicide methods,” added Dignitas.

“In Germany, the political-religious-dogmatic induced taboo around end-of-life choices must be done away with,” said Dignitas, which provides support and resources for those considering assisted suicide.

“Every individual should have the possibility to talk openly about his or her wish to have an end to his or her suffering without fear/risk of being labelled depressive, vulnerable, or incompetent with his or her doctor.”

The Federal Constitutional Court in Karlsruhe on Wednesday before discussing Paragraph 217. Photo: DPA

‘Active assistance’

The ban applies to only commercial services and those who “actively assist” with suicide. Relatives and loved ones who support a terminally ill person in his or her desire to die and drive him or her to Switzerland, for example, are exempt from punishment.

Since 2009, patients have been allowed to make their own decisions about the end-of-life treatments they receive, even if knowing that denying a specific treatment could result in death.

Yet under the current law, many palliative care assistants and many physicians fear that they could make themselves punishable with the treatment of terminally ill patients, reports DPA.

Several seriously ill people have also complained that they want to take their own lives with the help of an assisted suicide association.

Some of them have already died while waiting for a verdict to be reached. The constitutional judges had refused to repeal the law until a decision has been issued by the court.

Yet in 2017, when a severely disabled woman drove to Switzerland after a court denied her husband’s request for a lethal dose of sodium phenobarbital, the Federal Administrative Court ruled that a terminally ill person “in extreme individual cases” must not be denied access to an anaesthetic suicide.

However, the Federal Institute for Drugs and Medical Devices has not yet approved a single application out of the 123 requests it has received for life-ending drugs since 2018, according to a February 2018 report in the Tagesspiegel.

Dignitas urged that terminally-ill patients have a “freedom of choice” in their last matters, as did 80 percent of Germans surveyed in a recent ISO Public Poll on physician-assisted suicide.

“Freedom of choice is essential. Not 'must-do’s' and “must-not-do’s”,” Dignitas told The Local. “Suffering individuals who express a wish to have an end to their suffering – even if they express a wish for a physician-supported accompanied suicide – should be taken serious and not ignored or stigmatized.”