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Suicide as therapy: Federal Administrative Court presents written grounds for judgment
Suicide can also be medical therapy. The Federal Administrative Court in Leipzig clarifies this in the reasons for its decision of March 2, 2017, published in writing on May 17, 2017 (Az .: 3 C 19.15). Afterwards, critically ill people have to get permission to buy deadly medicines “in extreme exceptional cases”.
With his judgment, which had already been widely respected on the day of its announcement, the Federal Administrative Court had agreed with a man from Braunschweig. His wife had a serious fall in his own house in 2002. Since then she has been paraplegic and dependent on artificial respiration and constant care.
Again and again she had expressed the wish to end her life, which she perceived as suffering. However, the Federal Institute for Drugs refused to purchase a lethal dose of the active ingredient sodium pentobarbital. On February 12, 2005, the woman committed suicide in Switzerland with the help of the Dignitas association.
Her husband subsequently brought an action against the decision of the Federal Institute. Up to the Federal Constitutional Court, this was unsuccessful. The courts said the man was not affected and could not sue for his wife. Only the European Court of Human Rights (ECHR) in Strasbourg emphasized that the man also suffered severely from the suffering of his wife and therefore had his own right to lodge a complaint (Judgment and JurAgentur report of July 19, 2012, ref .: 497/09) .
Thereupon the Federal Administrative Court also dealt with the content of the lawsuit and decided that the Federal Institute should not have refused the deadly medicine here (on the same Az. Already JurAgentur report from the judgment day, March 2, 2017).
In its reasons for judgment, the Federal Administrative Court now emphasizes in the first place that the purchase of medicines 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 includes "the right of a seriously and terminally ill person to decide how and at what point in time his life should end". The general “duty of the state to protect life” must, in individual cases, resign behind this individual fundamental right. This was already recognized in palliative medicine and also when medical treatment was stopped, the Leipzig judges emphasized, referring to the case law of their colleagues at the Federal Court of Justice.
However, this protection of fundamental rights is not limited to cases in which the dying process has already begun. Therefore, the Narcotics Act must be interpreted in accordance with the constitution in such a way that exceptions are also permitted for suicide. Such an interpretation is possible, so submission to the Federal Constitutional Court is not necessary.
Because the Narcotics Act allows the delivery of narcotics for therapeutic purposes. The Federal Administrative Court then states verbatim: “In an extreme emergency of the kind described, the use of an anesthetic for suicide can exceptionally be regarded as serving therapeutic purposes; it is the only way to end an illness-related suffering situation that is intolerable for those affected. "
The Federal Administrative Court considers such an “extreme emergency” to exist under three conditions: First, there must be a “serious and incurable disease” that is associated with “serious physical suffering, especially severe pain, which cannot be alleviated”.
According to the Federal Administrative Court, the second requirement is that "the person concerned is capable of making decisions and has made a free and serious decision to end his life". Thirdly, finally, "another reasonable possibility of realizing the wish to die should not be available to him".
According to this third prerequisite, switching off medical devices, for example, would normally have priority over dispensing deadly medicines. In the event of a dispute, the conditions for an end to ventilation had not yet been clarified in 2004.
The Federal Administrative Court left open whether or not doctors can prescribe a lethal dose of narcotics under the above conditions. According to the Narcotics Act, such a regulation would no longer require permission from the BfArM. mwo / fle