Court allows suicide suicide as an optional therapy

Suicide as a therapy: Federal Administrative Court provides written grounds for judgment
Suicide can also be a medical therapy. This is clarified by the Federal Administrative Court in Leipzig in the reasons for its decision of 2 March 2017, published in writing on 17 May 2017 (ref .: 3 C 19.15). After that, seriously ill people must get permission to buy lethal medicines "in extreme exceptional cases.".

With his judgment, which had already received a great deal of attention on the day of the announcement, the Federal Administrative Court had given a man from Brunswick right. His wife fell heavily in his own home in 2002. Since then she was paralyzed and reliant on artificial respiration and constant care.

Dread and longing for death. People with suicidal thoughts need quick therapeutic help. Image: Johan Larson - fotolia

Again and again she had expressed the desire to be able to end her suffering as perceived life. However, the Federal Institute for Medicines denied her the 2004 requested purchase of a lethal dose of the hypoactive substance sodium pentobarbital. On February 12, 2005, the woman took the life with the help of the association Dignitas in Switzerland.

Subsequently, her husband filed a lawsuit against the decision of the Federal Institute. Up to the Federal Constitutional Court this was without success. The courts said the man was not affected himself and could not complain for his wife. Only the European Court of Human Rights (ECtHR) in Strasbourg emphasized that the man himself had suffered greatly from the suffering of his wife and therefore has his own right of action (Judgment and JurAgentur Report of 19 July 2012, Ref .: 497/09).

As a result, the Federal Administrative Court had also dealt with the substance of the case and decided that the Federal Institute should not have refused the lethal remedy here (on the same file, for example, JurAgentur Report of the Judgment Day, 2 March 2017).

In its judgment, the Federal Administrative Court emphasizes in the first place that the purchase of medicine for suicide is "in principle not permissible". The ban ultimately serves to protect the patients themselves.

However, the general personality right enshrined in the Basic Law "also includes the right of a seriously and incurably ill person to decide how and at what time his life should end". The general "protection duty of the state for the life" must withdraw in individual cases behind this individual basic right. This is already recognized in palliative medicine and also in the discontinuation of medical treatment, emphasized the Leipzig judges, pointing to the case law of their colleagues in the Federal Court.

However, this protection of fundamental rights is not limited to cases in which the dying process has already begun. Therefore, the narcotics law must be construed in accordance with the constitution that exemptions are also permitted for suicide. Such an interpretation is possible, a submission to the Federal Constitutional Court therefore not necessary.

Because the Narcotics Act allows the delivery of narcotics for therapeutic purposes. The Federal Administrative Court then makes the following literal remarks: "In an extreme emergency of the kind set out, the use of an anesthetic for suicide may exceptionally be regarded as a therapeutic purpose; it is the only way to end a disease-related, unbearable suffering for the person affected. "

The Federal Administrative Court considers such an "extreme emergency" to exist under three conditions: First, there must be a "serious and incurable disease", which is associated with otherwise unimaginable "serious physical suffering, especially severe pain".

The second requirement, according to the Federal Administrative Court, is that "the person concerned has the capacity to make decisions and has decided freely and seriously to want to end his life". Thirdly, finally, "another reasonable possibility for the realization of the wish to die may not be available to him".

For example, according to this third condition, the shutdown of medical devices would normally take precedence over the delivery of lethal drugs. In the case of the dispute in 2004, the conditions for an end to ventilation had not yet been clarified.

The Federal Administrative Court left open whether doctors could prescribe a lethal dose of narcotic drugs under the aforementioned conditions. According to the Narcotics Act, such a decree would no longer require a permit from the BfArM. mwo / fle