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Medical Ethics

DW staff (th)November 24, 2008

A new survey shows that a surprising number of German doctors have no moral qualms about assisted suicide. A full 35 percent would support rules allowing doctors to help terminally ill patients end their lives.

Patient's hand held by a doctor
Ethical concerns keep most doctors from assisting with suicidesImage: AP

The anonymous survey of 483 doctors was conducted for the German news magazine Der Spiegel. A full 40 percent of doctors indicated they could imagine helping a patient end his or her life, the survey found. And 16 percent of doctors said they could envision themselves taking the lead role in helping a patient commit suicide.

Assisted suicide became a hot topic in Germany earlier this year after Roger Kusch, an ex-senator in Hamburg, advised an elderly woman on how to prepare a deadly cocktail of drugs. In the wake of the woman's suicide, politicians have called for laws that would make it illegal for anyone to help someone kill themselves or give them advice on how to do so.

Violation of medical ethics

The doctors taking part in the survey were general practitioners, oncologists, internists, anesthesiologists or palliative medicine practitioners who deal with extremely ill patients in hospitals. The survey found that 3.3 percent admitted to having helped patients commit suicide on one or more occasions.

Doctors visit a patient in the hospital
Most doctors have little training in end-of-life careImage: dpa

In Germany, assisted suicide is illegal, as long as no one physically helps end the person's life.

But doctor-assisted suicide is widely viewed in Germany as violating the code of professional medical conduct and is seen as going against doctors' legal duties to save lives. Assisted suicide also has also been stigmatized due to the Nazi eugenics programs which killed more than 70,000 mentally ill and handicapped people.

Hospice organization decries attitude

In the survey, 44.5 percent of the doctors said that if they were in the situation of being terminally ill, they would want a colleague to be allowed to help them commit suicide. Nearly one in three said they would want "active" help from a doctor.

Germany's hospice organization said that the results show the need for more ethical training for the medical profession and more money for terminal care.

For the German hospice association, the survey shows "what a bad handle doctors have on ethical and medical questions." Only four percent of terminally ill patients had access to professional end-of-life care in the last 12 months before their deaths, said Eugen Brysch, who heads the hospice association. He said that many doctors cannot differentiate between "allowing someone to die" and "killing" someone.

The hospice organization wants to see the German government, as well as states and medical groups, invest 30 million euros ($38 million) each year in ethics training.