Euthanasia is forbidden in Germany, but there are at least 12 groups or individuals that offer legal assistance to those who wish to die, an investigation on political programme Report Mainz revealed on Tuesday. Last year, they helped at least 155 people commit suicide.
Offering support, medical advice and if needed the means to end a life, Dying Assistance Germany (StHD) is one of these groups. Founded in 2009 by former Hamburg state minister for justice Roger Kusch, it helped 40 people end their lives in 2013.
Its symbol is a black ribbon. Its patients suffer from chronic, incurable and often painful diseases. They die under the supervision of a member of staff.
And a Forsa poll released on Thursday by StHD, which quizzed 1,005 people in Germany, showed 70 percent would like the option of assisted suicide if they became seriously ill.
A Swiss assisted suicide clinic run by Dignitas also offers help to Germans - more than those of any other nationality. Since opening in 1998, Germans have made up over 56 percent of people opting to die there, totalling 840 people. Of those deaths, 92 took place last year.
German branch Dignitas Deutschland is not legally allowed to offer the same service as its Swiss parent clinic, but it campaigns for the right to die and puts Germans who wish to commit suicide in touch with their Swiss colleagues.
But not all of these “dying assistants” work in groups. One man operating outside of an organization is 70-year-old Peter Puppe, an ex-school deputy headteacher. Report Mainz heard how he admitted to helping four or five people to die every year since 2005, most often using a lethal mixture of drugs.
"I help when it is a case of a serious illness without any expectation of improvement or medical help, let alone recovery, and the definitive message over a long time is, 'I don't want to live anymore'," he said. He takes no active part as this would count as illegal “active suicide assistance”.
Helping may soon be illegal
This sort of passive assisted suicide - not to be confused with euthanasia which can imply active involvement in the death - offered by Puppe, the StHD and others is perfectly legal in Germany, Munich-based medical ethics lawyer Wolfgang Putz told Report Mainz.
"This self-styled 'dying assistant' is acting entirely within the law so long as the people enlisting his help do so of their own free will," Putz said. "It all boils down to whether the patient who wants to commit suicide is willing and has properly considered beforehand," he added.
But that could be set to change as ministers from Chancellor Angela Merkel's conservative bloc, including health minister Hermann Gröhe and CDU general secretary Peter Tauber, plan on passing through parliament a ban on all forms of assisted death where money changes hands.
Gröhe said in an interview on January 6th with the Rheinische Post newspaper that it was "reprehensible" to make money from assisted suicide. Tauber, meanwhile, has called for a blanket ban.
Patients put off by taboo
Even without a legal hindrance, though, many patients may be held back from pursuing assisted death by the practice's controversial nature and confusing the legal and ethical background.
A study from the Institute for Medical Ethics at Ludwig-Maximilian University in Munich, included in Report Mainz, showed that of 66 patients suffering from muscle-wasting disease ALS, 42 percent had considered suicide and 50 percent could see themselves asking a doctor to help them end their lives.
Despite this, the results also showed very few patients thought they could actually bring themselves to talk to a doctor about assisted suicide.
Ralf Jox, who led the study, told Report Mainz it was a "taboo in the relationship between doctor and patient," and recommended regulation and control of the practice instead of a ban, which he said would not be doing right by patients.
Free Democrat (FDP) politician Wolfgang Kubicki also added his voice to calls for the legalization of assisted suicide in an interview with Die Welt newspaper.
Kubicki's brother died slowly of apallic syndrome, known as Persistent Vegetative State. He told the paper: "It is of central importance for me that people have the right to end their lives on their own terms.
"The state cannot presume to categorically ban citizens from such a personal decision using law.”
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