Germany : Doctors are Calling for Greater Means For Suicide Prevention


During the World Suicide Prevention Day, Bundesärtzkammer, the German medical association, praised the resolution for the prevention of suicide adopted by a strong majority at the Bundestag, after the German members of parliament rejected two texts intended to regulate medically assisted suicide. The medical association is asking for the suicide prevention policy to be backed up by adequate financial means.

On 6th July, two cross-party bills were tabled at the Bundestag to provide a legal framework for medically assisted suicide. In fact, since the decision by the constitutional court on 26th February 2020 which overturned a law from 2015 prohibiting the commercial organisation of assisted suicide, it has been performed by associations in the absence of any legal framework. According to the figures from the main associations currently providing assisted suicide services in Germany, they helped some 350 people to die in 2021. The doctors use sedatives such as midazolam, for example.

Both bills tabled on 6th July attempted to provide a legal framework for the practice by establishing regulations. One of the bills, from Lars Castellucci, of the social-democrats (SPD) party, and Ansgar Heveling, of the Christian-democrats (CDU) party, stipulated that assisted suicide should remain prohibited but that exceptions could be made for adults after two mandatory interviews, with a minimum three-month cooling-off period between the two interviews. The other bill, tabled in particular by the liberal Katrin Helling-Plahr and ecologist Renate Künast, which was less restrictive, established a right to assisted suicide for adults and authorised doctors to prescribe a lethal substance between three and twelve weeks after a mandatory interview.

The assisted suicide associations were opposed to both bills as they did not wish assisted suicide to be regulated, arguing that the current legal framework is quite clear enough, and rejected the idea of any mandatory interview.

Meanwhile, the players concerned with suicide prevention voiced reservations regarding the establishment of approved counselling centres in order to conduct suicide candidate interviews. In their opinion, it would be better to provide long-term funding and to federate the existing regional structures, as well as the telephone and internet help lines. The second bill was particularly criticised by the suicide prevention specialists because the intended three-week minimum cooling-off period is much too short to be able to overcome a suicidal crisis through support.

Both bills were eventually rejected. However, the Bundestag parliament adopted by an overwhelming majority of 688 votes (a single vote against) a resolution to reinforce suicide prevention. This resolution calls on the Government to table a bill and a strategy for suicide prevention by 30th June 2024. A unique national telephone help line must be set up for people having suicidal thoughts and their close relations.

In a recent statement, the medical association praises this initiative. It also welcomes the announcement made by the Health Minister that work has already begun on a national strategy. However, according to them, it is essential that suicide prevention should not remain a mere concept. “The proposals experimented and the structures must not be abandoned for financial reasons and a national agency for information and coordination of suicide prevention must not be allowed to fail for lack of funding”. According to Dr. Stefan Schumacher, in charge of the telephone help line, the people experiencing a suicidal crisis do not always have ready enough access to a telephone or internet help line, due to a lack of capacity. It is therefore essential to increase accessibility through coordination at the national level. On her side, Claudia Bausewein, President of the German Society for Palliative Care, regrets the unequal accessibility to palliative care and a great variety of information according to the diseases. “The step towards assisted suicide sometimes appears a lot easier” she warns.

As can be seen, the failed attempts at establishing a legal framework for assisted suicide in Germany clearly show the impossibility of reconciling the regulation of assisted suicide and a policy for the prevention of suicide. A coherent policy for suicide prevention cannot suffer any exceptions.



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