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An unusual, highly emotional debate in German parliament ended with the majority expressing support for prohibiting organized assisted suicide. But not all representatives called for an outright ban of the practice.
Such debates are a rarity in parliament. Over the course of five hours, 48 speakers took to the podium - and there wasn't even a bill up for debate. Parliamentarians clearly felt it was important to take the time for an open discussion on an unusual topic that Parliamentary President Norbert Lammert called the "most demanding legislative procedure" of the current legislative period.
Opinions on the issue of assisted suicide transgressed party lines. Many MPs admitted to not yet having come to a definite opinion on the issue. The debate was meant to provide orientation. At times, representatives spoke of very personal experiences and did not shy away from a showing emotion. "Today's debate was not the usual, pragmatic debate aimed at balancing different interests; this was about an exchange among human beings," said Annette Widmann-Mauz, a member of Chancellor Merkel's Christian Democratic Union (CDU).
Majority opposed to the business of death
Volker Kauder (CDU) reminded everyone present why it was necessary for the issue to become a political one. Suicide and assisting a suicide are not legally regulated in Germany. Every citizen also has the right to issue a patient's directive to prevent medical treatment aimed at artificially prolonging life. But Kauder pointed to a recent development that he said is a cause for concern: Organizations that offer assisted suicide services to their members. He said it was a "perversion" that, according to the amount in membership dues paid, assisted suicide services would be provided either immediately, or after a certain waiting period. "What does that have to do with humanity? " he asked. "Is that something we want to have in our society?"
It seems the answer is no, at least according to the majority of MPs who spoke out against organizations actively providing assisted suicide services. Several speakers mentioned the experiences of other countries grappling with the same issue. Hubert Hüppe (CDU) raised the fear that health insurers would, in the end, only cover suicide for terminally ill people, as he said had occurred in the US state of Oregon.
"Supply creates demand" also applies to the experience of the Netherlands and Belgium, said Michael Brand (CDU). He added that an assisted suicide law in Belgium has been changed 25 times in order to extend assisted suicide rights to those suffering from dementia, children, or sex offenders. "Those who open the door even just a little will find that they can't close it anymore, " Brand said.
Legal uncertainty for doctors
In contrast, some members of the opposition Left Party and Greens shared the view that organization providing assisted suicide services should be permitted in future.
Renate Künast of the Greens said the current legal situation is better than the alternatives that have been suggested. Petra Sitte of the Left Party said organizations could provide competent assistance to the terminally ill. She asked whether we must equate active assisted suicide with a disregard for human life.
Karl Lauterbach, a health expert for the Social Democratic Party (SPD), countered by arguing that the current situation in Germany doesn't work well. Among the dead are many cases of people with mental illnesses who might have been saved. He added that many doctors are unsure about the legal implications of their actions.
Lauterbach supported a position paper calling for clearer guidelines for doctors contemplating helping a patient commit suicide. Medical associations in Germany have yet to adopt a unified position on the issue.
Katherina Reiche (CDU) said a "legally protected space" between a patient and a trusted physician to act according to their conscience would make assisted dying organizations superfluous. Doctor and parliamentarian Sabine Dittmar (SPD) recommended more legal certainty in order to regulate the conflict between criminal law and the professional code of conduct for doctors.
Forgoing a legal regulation for the established "borderline cases where palliative care can't help anymore" is "cowardly" said former Minister of Family Affairs Kristina Schröder (CDU). She called for a "cautious correction" to "spare doctors consequences from laws specific to their profession" should they assist in a suicide. That would require a legal provision, she said.
Health Minister Hermann Gröhe (CDU) took a first step towards such a provision this week. But representatives have demanded that much more still be done in this area.
A draft bill on assisted suicide is likely to be brought before parliament in February, at which point the political back and forth will begin. It's a topic that will be with parliamentarians for a while yet to come.