German Court Liberalises Rules For Right-To-Die Cases

German court liberalises rules for

right-to-die cases, June 25, 2010.

BERLIN — In a landmark ruling that will make it easier for people to allow relatives and other loved ones to die, Germany's highest court ruled Friday that it was not a criminal offense to cut off life-sustaining treatment for a patient.

The court overturned the conviction of a lawyer who last year was found guilty of attempted manslaughter for advising a client to sever the intravenous feeding tube that was keeping her mother alive, although in a persistent vegetative state. The mother had told her daughter that she did not wish to be kept alive artificially.

The verdict is likely to spur significant changes in the practice of assisted suicide and is certain to restart the debate over euthanasia and the right to die in Germany.

In its decision, the court clearly distinguished between “killing with the aim of terminating life” and an action that “let a patient die with his or her own consent.”

The ruling strengthens an individual’s right to die with dignity, since terminating life-sustaining treatments will no longer be a crime if patients have declared their wishes.

The lawyer, Wolfgang Putz, an expert in patient rights at the Ludwig Maximilians University in Munich, called the decision “outstanding.”

“It protects against abuse and it sets down clear boundaries,” Mr. Putz said in a telephone interview on Friday after the verdict. “It helps the patients and it helps the doctors. It takes away at last the fear of punishment.”

There has been a growing debate in Europe over assisted suicide, particularly in Britain. In February, a British filmmaker, Ray Gosling, was arrested after he admitted that he had helped kill a former lover. Euthanasia with the consent of the patient — sometimes called voluntary euthanasia — is legal in some European countries, including Belgium and Switzerland.

For years, Germans have traveled to Switzerland to die. But it is an especially difficult issue here because the Nazis used the term euthanasia as cover for a mass extermination program of disabled people.

“The verdict transmits a fatal signal that does not comply with the critically sick people’s fundamental right to self-determination and care,” said Eugen Brysch, the director of the German Hospice Foundation, in a statement on Friday. Mr. Brysch took exception, in particular, to the fact that the woman, Erika Küllmer, expressed her wish orally rather than in writing.

“If, as in this case, a casual private conversation without sufficient witnesses is enough to determine the patient’s wishes, then the floodgates for misuse are wide open,” Mr. Brysch said.

But Germany’s justice minister, Sabine Leutheusser-Schnarrenberger, applauded the decision by the high court in Karlsruhe.

“In a difficult phase of life, wills by patients provide safety for patients, relatives, doctors and nurses,” Ms. Leutheusser-Schnarrenberger said. “The will freely formulated by a human being must be respected in all circumstances of life.”

In the case before the court, Ms. Küllmer was in a persistent vegetative state for five years after suffering a cerebral hemorrhage in 2002. Although she had expressed the wish not to be kept alive under such circumstances, the management at her nursing home had refused to let her die.

The lawyer for Ms. Küllmer’s children, Mr. Putz, advised them to cut the tube in 2007, which the daughter did. The patient died of heart failure two weeks later.

In 2009, a district court in Fulda gave the lawyer a suspended sentence of nine months for attempted homicide. The daughter was acquitted.

“For me it was always clear that I have done the right thing,” Elke Gloor, Ms. Küllmer’s daughter, told the German news agency DPA after the hearing.

Germany’s conservative chancellor, Angela Merkel, declared in 2008 that she was “absolutely against any form of assisted suicide, in whatever guise it comes.”

Those comments were made in the wake of a scandal after a German campaigner for assisted suicide, Roger Kusch, helped Bettina Schardt, a retired X-ray technician from the Bavarian city of Würzburg, kill herself at home even though she was not sick or dying; she simply had not wanted to move into a nursing home.

Rudolf Henke, the chairman of the Marburger Bund, the German doctors’ association, said in a statement that the acquittal of Mr. Putz should not be seen as “a license for independent action while making decisions on the continuation of life-sustaining measures.”

“Before life-sustaining measures are stopped, legal regulations must determine what kind of action is required to reflect the will of the patient,” Mr. Henke said. “The killing of people remains prohibited.”

By Victor Homola & Nicholas Kulish, New York Times