Talking about Dying with Dignity

Assistance in Dying with Dignity

There are different forms of assistance in dying.

• Passive euthanasia - Allowing to die by forgoing life-prolonging medical treatment or high-dose, life-shortening pain treatment, such as morphine (indirect euthanasia), are forms of euthanasia that a patient can make binding in a good living will. 
• Active euthanasia - Killing on demand, in which a doctor injects a lethal substance into the patient at his request is prohibited in Germany and in Switzerland. 
• Assisted suicide or suicide assistance (by physicians or others) with a self-determined end of life - is expressly permitted – and even declared a fundamental right by the Federal Constitutional Court. In contrast with the different forms of “euthanasia”, the decision-making process remains with the person (as outlined below) who wishes to end their own life. The patient decides on the end of their life and intentionally brings about his/her own death. In Germany and a few other countries, this assistance is legal as long as anyone abetting or helping another person to commit suicide does not have any selfish motives.

Living on until death comes by natural causes - this for sure THE alternative to any suicide assistance. And a argument which is mentioned so often - yes the quality of continued life in case of a serious illness can be improved with pain-relieving treatments from palliative and conventional medicine in most cases, and in combination with other therapies, palliative sedation or psychological support. But nobody should be forced to choose these alternatives, but an informed and well-considered decision regarding a suicide requires that the one who want to pass away is aware of the alternatives. And that a person want their death beside of knowing these alternatives gives safety to them and to the one who are asked to help or accompany the person is diseased, suffering or just tired to wait for a natural death.

Talking about Dying with Dignity

I am a firm believer that spouses, cohabitant partner, close relatives and best friends should be included in suicidal considerations as early as possible. The more time someone has to internalize the intended suicide of a loved one, the better they will be able to accept the impending farewell. (Please have a look at a former Article)

However, there are sometimes good reasons why the person who is willing to die does not want to involve their relatives and friends, for example if they fear that they could prevent the suicide due to very deep emotions combined with lacking conviction or excessive dependence, fear of loss or because of their own for conscience' sake or religious sake. 

For those who want to die - if relatives are willing to assist in the suicide - this is for sure the best and pleasant way to do it - than having to set the date of the suicide days in advance with an association with unfamiliar people - it is so much better having a few of their beloved relatives and friends around them.

Status Quo of Dying with Dignity

The German Federal Constitutional Court (Bundesverfassungsgericht) has ruled that a decision to commit suicide is based on an autonomously formed, free will if the individual makes his or her decision on the basis of a reality-related weighing of the pros and cons based on his or her own self-image / self-perception. On the one hand, the decision to commit suicide must therefore be free, which means that it is not the result of an acute mental disorder. On the other hand, the suicidal person must recognize and weigh up the pros and cons of alternative options - as mentioned before - understand and evaluate  the respective consequences and make their own decision by knowing of all relevant circumstances and options.

The suicide assistance by an association or by relatives can take place at the home of the person who want to commit suicide , i.e. in their home or in the home of relatives. It is as well possible to do it at a care or nursing home but in this case it is needed to get check whether the management will tolerate suicide assistance - and that might be tricky as most of these  care or nursing home are owned by theological or religious institutions.

Former Articles in this Context:

We should give dying people the right to leave this world with dignity - Desmond Tutu

Autonomy how to live and how to die

Inform Family and Friends of a forthcoming Death with Dignity

December 29, 2021