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ASSISTED SUICIDE

German court strengthens patients’ rights in assisted suicide ruling

Judges in one of Germany's top courts said Wednesday that two doctors who stood by as patients committed suicide must not be punished.

German court strengthens patients' rights in assisted suicide ruling
Photo: DPA

Prosecutors had asked the federal court of justice to clear the two defendants, both doctors who did not intervene when their patients deliberately took fatal doses of medication.

Their actions “did not constitute a homicide”, presiding judge Norbert Mutzbauer in Leipzig said.

“If the patient kills themselves, even with help from someone else, that person's actions are not punishable under the law.”

In advance of the decision, the German Foundation for Protection of patients had told news agency DPA it would draw new lines “between permissible assisted suicide in individual cases, and forbidden killing on demand”.

SEE ALSO: German court discusses legality of assisted suicide

While doctors in Germany may not actively kill patients, in some circumstances they can agree to patients' requests to withhold treatment, or provide treatment that provides a benefit like pain relief at the cost of shortening life.

But the sick person must be of sound mind and under no external pressure in order to legally agree to such interventions.

A lower Hamburg court had cleared one of the defendants, a neurologist and psychiatrist from the northern city.

He had certified the decisions of an 81-year-old and an 85-year-old woman to end their lives and was present when they took deadly doses of medication in 2012.

Both were suffering from multiple non-fatal illnesses that restricted their quality of life.

Meanwhile the other doctor was cleared by a Berlin court after providing a fatal drug in 2013 to a 44-year-old woman who had suffered chronic pain for almost 30 years.

He was present as she died and made no effort to prevent it.

In a “fiendishly complicated situation of conflict”, it had been his “moral duty” to help the woman, Berlin doctor Christoph T. told the federal court, appealing to the Christian injunction to love one's neighbour.

Hamburg doctor Johann Friedrich S. had urged the court to reach “a decision supporting citizens' right to make decisions about themselves.”

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EUTHANASIA

Switzerland: What is the difference between assisted suicide and euthanasia?

While the terms often are used interchangeably, assisted suicide and euthanasia - and the laws that govern them - are quite different. Here’s what you need to know.

A person in a medical coat holds hands with another
Euthanasia and assisted suicide might be spoken of in the same breath, but they are quite different. Here's what you need to know. Photo by Matheus Ferrero on Unsplash

The terms assisted suicide, assisted dying and euthanasia are often used interchangeably – even by media and politicians covering the matter. 

There are however some key differences, both in terms of the legal situation and the practice itself. 

Assisted suicide is where a medical professional, usually a doctor but sometimes a pharmacist or other specialist, provides some form of medication to assist a patient as they commit suicide. 

EXPLAINED: How foreigners can access assisted suicide in Switzerland

Crucially, it is the patient who takes the final step, i.e. by taking a medication or by pressing a switch through which the medication is administered. 

Euthanasia on the other hand is where the medication which ends someone’s life is administered by a doctor or medical professional. 

Euthanasia is sometimes known as voluntary euthanasia, which references the fact that the patient volunteers for the process by providing consent. 

Other forms of medical intervention which lead to death – for instance turning off life support for someone who has been in a long-term coma – do not fit within the definition of voluntary euthanasia. 

The term ‘assisted dying’ is used as a grouping term to refer to both assisted suicide and euthanasia, although media sources – particularly in the United Kingdom – often use assisted dying when referring primarily to assisted suicide. 

What are the rules for assisted suicide and euthanasia in Switzerland? 

The law in Switzerland recognises the distinction between assisted suicide and euthanasia. 

Euthanasia is not permitted under law in Switzerland, while assisted suicide is allowed for both locals and foreigners. 

While article 115 of the Swiss penal code prohibits assisted suicide for “self-serving reasons” and article 114 prohibits “causing the death” of a person for “commendable motives, and in particular out of compassion for the victim”, assisted suicide for non-selfish reasons is not specifically prohibited as long as certain conditions are met. 

The Swiss supreme court has ruled the following: people must commit suicide by their own hand, for example, by taking medication themselves. A doctor cannot administer a lethal injection without being liable for criminal prosecution.

People must also be aware of actions they are undertaking and have given due consideration to their situation. In addition, they be consistently sure they wish to die, and, of course, not be under the influence of another person, or group of persons.

READ MORE: What you need to know about assisted suicide in Switzerland

Several other jurisdictions across Europe and the globe also make a legal distinction between the two, although euthanasia is legal in some countries including the Netherlands, Belgium, Luxembourg and Columbia. 

What is the medical procedure involved?

Most Swiss associations request that patients drink sodium pentobarbital, a sedative that in strong enough doses causes the heart muscle to stop beating.

Since the substance is alkaline, it burns a bit when swallowed.

A professional prepares the needle, but it is up to the patient to open the valve that allows the short-acting barbiturate to mix with a saline solution and begin flowing into their vein.

A video is shot of the patient stating their name, date of birth and that they understand what they are about to do. The camera keeps rolling as they open the valve and the footage is used as evidence that they willingly took their own life.

It usually takes about 20 to 30 seconds for the patient to fall asleep.

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