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HEALTH

What are the rules for assisted suicide in Austria?

Assisted suicide is a controversial topic in Austria, and the current rules have again been challenged in the Supreme Court. Here's what's going on.

People holding hands in a hospital bed
What are the rules on assisted suicide? (Photo by Jon Tyson on Unsplash)

In Austria, assisted suicide (when the patient decides to end their life and carries out the last act themselves) is permitted under certain conditions after a ruling by the Constitutional Court, which came into force in 2022.

However, the issue is back in Austria’s highest court after a group of people found the current rules too strict, according to a Kurier report. In one case, a patient claims assisted suicide is not enough and aims to be allowed to receive active euthanasia. The difference is that currently, only the patient themselves can take the infusion that will kill them; it would be illegal for someone else to administer the solution.

One of the plaintiffs with the Constitutional Court, Nikola Göttling, has a neuropsychological illness that is slowly killing her, the Kurier said. She told the newspaper that she fears she will miss “the right moment”, that point just before she is paralysed and unable to take the lethal drug without assistance.

READ ALSO: Everything foreigners need to know about the Austrian healthcare system

So, what are the rules for assisted suicide?

The Austrian ruling on the issue is complex. People who want to go through with it need to make a Sterbeverfügung, which could be translated as a “dying will”. They must be adults and capable of making a decision, and they must perceive their condition as suffering that cannot be avoided in any other way.

The process for such a will is long. First, two physicians (one that could be a general practitioner and the other who must have a palliative qualification) have to “clarify” the situation to the patient. They will also confirm the existence of the illness and independently verify the person’s decision-making capacity.

If one of the doctors doubts the patient’s decision-making capacity, it needs to be reassessed by psychiatrists or psychologists.

READ ALSO: How do Austria’s new plans on assisted suicide compare to others in Europe?

After that, the patient needs to wait a period of 12 weeks before the will can be drawn up – “this period is seen as necessary to overcome crisis phases”, according to the federal government. There is a shorter deadline of two weeks for people in the terminal phase, with only a few weeks to live.

Finally, the “dying will” can be drawn up with a notary or lawyer. With it, the person who wants to die can collect a lethal preparation from a pharmacy and then take it themselves. If the patient is bedridden, an authorised person can pick it up, or the pharmacy can deliver it – however, the patient needs to be able to take it themselves.

“That means great stress for me, If it were possible for someone else to help me die, that would be life-prolonging in my case,” said Göttling, who told the Kurier that she wanted to live for as long as possible but that the current law forces her to take the step earlier.

BACKGROUND: Austria court rules assisted suicide must be legalised

What are some of the criticism?

Some groups have already objected to the law and filed suits with the Constitutional Court in Austria. 

The Austrian Society for a Humane End of Life (ÖGHL) also argues that the “rigid ban on communication” makes it impossible for people to get the information they need on their rights, according to an ORF report. 

“We receive many inquiries from people seeking help who cannot find their way around the law. We would like to help as an association, but we are not allowed to”, they told the broadcaster.

The long waiting period of 12 weeks is also criticised, as organisations say it exposes those affected to the risk of them no longer being able to carry out suicide.

Additionally, a “conscience clause” in the regulation also states that no one is obligated to offer or perform assistance in establishing the will, which means that, for example, pharmacists can deny dispensing the preparation. 

In 2022, 111 dying wills were registered. However, the number of people who actually took the lethal drug is significantly lower, according to the Kurier.

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HEALTH

When can I ask for reimbursement for medical expenses in Austria?

If you visit an 'elective doctor' in Austria or go for certain procedures and examinations, you might have to pay the costs upfront. But when will your statutory health insurance reimburse you?

When can I ask for reimbursement for medical expenses in Austria?

Austria’s health system can seem complicated. Most people are insured by statutory insurance companies, ensuring they receive quality care for free in the country. 

However, there may be times when you want to go the private route – be it for specific examinations, or if you are searching for a particular specialist or, most commonly, if you just can’t or won’t wait to get an appointment via the public system. As the number of public doctors drops, more and more people have reached out to the “elective” doctors, or to private laboratories for certain exams instead of waiting weeks in the public system.

In those cases, the public health insurance funds often reimburse your expenses, at least partially. 

READ ALSO: Six things to know about visiting a doctor in Austria

When can I ask for reimbursement?

There are several cases when you can be reimbursed by Austria’s largest health insurance company, the ÖGK. These include:

  • Private or elective doctors: Elective doctors do not have a contract with the Austrian Health Insurance Fund (ÖGK). You will therefore be treated there as a private patient and must initially pay for the treatment yourself. In most cases, ÖGK will reimburse part of the costs.
  • Dental Health: In addition to conservative dental treatment and dentures, the ÖGK dental services also include jaw adjustments (braces).
  • CT, MRI and x-rays: Computed tomography (CT), magnetic resonance imaging (MRI) and X-rays are “diagnostic imaging procedures”. The Austrian Health Insurance Fund (ÖGK) covers the costs if the examination is carried out at an authorized institute.
  • Therapists: the ÖGK will cover costs for speech therapy, physio therapy and psychotherapy, among others. You can read more HERE.
  • Midwives: Midwives support women during pregnancy, during childbirth and in the initial period afterwards. The Austrian Health Insurance Fund (ÖGK) covers certain costs for the midwife.
  • Hospital stays: Persons insured with the Austrian Health Insurance Fund (ÖGK) can receive outpatient or inpatient treatment in certain hospitals throughout Austria. The fund will not cover any special fees that are incurred for accommodation in “special class” (some hospitals offer private rooms as special class, for example). For medically necessary treatment in hospitals with which there is no contractual relationship,  ÖGK currently pays a daily care cost allowance of € 399.97, but not more than the actual costs incurred.
  • Medical aids and medication: The Austrian Health Insurance Fund (ÖGK) covers the costs of medical aids and aids such as hearing aids, diabetes supplies or bandages if you have a doctor’s prescription for them. The ÖGK also covers medication costs, but you need a prescription from a doctor. 

READ ALSO: How much can you expect to pay for private healthcare in Vienna?

How much will I get?

The reimbursement does not cover the whole cost. Once the reimbursement is approved, you will get 80 percent of what the ÖGK would have paid to the public system. This is not the same as 80 percent of your invoice.

The insurance fund doesn’t always approve invoices, it will evaluate the need and set up limits (so, you won’t get a refund on every doctor’s visit if you go to the same specialist type in a short period, for example). Particularly if you plan on a big expense, it’s worth it to check with the fund beforehand if they would cover the private costs.

How can I claim reimbursement?  

You first need to obtain receipts for all medical expenses, including doctor’s invoices, hospital bills, and pharmacy receipts. You’ll also need to gather payment confirmation. Then, you submit this information as a claim request on the website of your insurance company. With ÖGK, the link is HERE.  

You then wait for the processing time, which can take up to several weeks. If your request is approved, you’ll receive the money back straight to the bank account you have in your account details on the insurance website. 

READ ALSO: Will my Austrian health insurance pay for medical expenses abroad?

What if I have private insurance?

Most private insurance in Austria work with statutory companies. You’ll follow the same exact path. Once you get confirmation of how much the public insurance will reimburse you (or if it won’t reimburse you), you can then send all these documents to your private insurance. They will pay the difference between what you got from the public company and what you paid in private healthcare.

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