Despite the unfavourable experiences in neighbouring countries, despite the fatal experiences from German history and despite the warnings from suicide research, euthanasia is promoted under the titles “Assisted Suicide” and “Death on Demand”.The public debate about whether a doctor may assist in suicide causes great harm to people’s minds. By this debate fundamental ethic principles of our social coexistence are challenged. If it is given “to the attending physicians in the hand to meet a killing desire, the doctor-patient relationship is deeply shaken.”1.
It is high time we, as doctors, position ourselves:
The moral state of a civilised society is measured by how it deals with the weakest. The protection of life is enshrined in the European Convention on Human Rights and in the Universal Declaration of Human Rights from 1948.
The top priority of medical practice is not to harm the patient. The doctor is the protector of life he must not be a danger to the lives of his patients. It deeply contradicts the medical ethos of 2400 years and the humanity of everyone to execute assisted suicide on a suffering person.
Every mentally or physically ill person needs expert medical help and genuine compassionate care, as well as the assurance that the doctor will do everything possible to heal his illness or, if this is not possible, relieve his suffering.
The desire for assisted suicide is not primarily the result of fear of unquenchable pain, but of worrying about being a burden on others, being at the mercy of others, of losing control, or being alone.
Patients who express a desire to suicide usually do not expect their death to be caused. Mostly, the desire for assisted suicide is a cry for help and of temporary nature.
Proceeding from the actual medical-psychiatric understanding suicidality is by far the greatest part symptom of a psychiatric disorder or closely related to a psycho-social crisis.
Therefore, the will of the suicidal person is not “free” in the positive sense of the word; on the contrary, the person concerned must be protected against a short act as well as against the actions of third parties, namely those of people who perform assisted suicide.
There is no justification for the medical assistance to suicide for a patient. Due to medical advances and social ties, today we are able to care for seriously ill and dying people in such a way that they do not suffer unbearably, but feel safe and cared for.
It is human nature that even at the end of life we are reliant on our fellow human beings. A limitation of our autonomy or of our self-determination does not result from this.
The assisted suicide presupposes that a human life is judged by a third party, namely a person who performs assisted suicide, as unworthy to live. But this is already the limit to euthanasia exceeded. The escalation of killing with and without demand of the patient in the Netherlands since the 1990s must be a warning to us.
If the doctor does not want to unnecessarily prolong the suffering of a seriously ill, dying person and therefore refrains, reduces or terminates a medical measure, he does not make himself liable to prosecution. He is also allowed to apply an indicated palliative treatment even then if thereby not willingly the life of the patient may possibly be shortened.
Given these alternatives, there is no need to worry that in case of a serious, incurable, and fatal disease, the patient’s suffering would be unnecessarily prolonged. Moreover, a good palliative care can have a suicide-preventive effect.
We physicians in Germany due to our history have a special obligation to stand up for the protection of our patient’s lives.
We join the valid position of the World Medical Association (WMA), “[…] that euthanasia and physician assisted suicide are unethical and we say they must be condemned by the medical profession. We strongly encourage physicians to refrain from participating in euthanasia, even if national law allows it or decriminalises it under certain conditions”. (Dr Ardis Hoven, Chair WMA-Council. www.wma.net/news-post/major-end-of-life-conferences-organised-by-world-medical-association/.)
1 Professor Dr med.h.c. Peters, Uwe Henrik. Preface. In: Arbeitsbündnis “Kein assistierter Suizid in Deutschland!” (Ed.) Eine Auswahl der Publikationen. Edited on occasion of the World Congress on Psychiatry in Berlin, October 2017, Cologne, p.3
(Translation Current Concerns)
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