Terminal sedation, euthanasia, assisted suicide – the English language offers many circumscriptions for one big issue that is being debated all over Europe. The discussion was reignited most recently by Belgian plans to make assisted dying a possible option for terminally ill children and dementia sufferers too, as well as the deaf Verbessem twins’ wish to die as they were going blind at age 45. Their death wish was ultimately granted, and carried out in December – just a few weeks ago. 2014 may be the year in which the debate around assisted suicide will gain momentum internationally. For years now, if not decades, West European countries have faced tough socio-political dilemmas posed by ageing societies, the rise of Alzheimer’s and other forms of dementia, the continuous ‘battle’ with cancer, and the all-too-long avoided question of how much autonomy over their own bodies we grant, or deny, those who are severely and terminally ill.
All of these challenges do, of course, play into the debate.
In Germany, the members of the Bundestag (the German parliament) will soon vote on the revision of the German law on the matter. Currently, the law tolerates ‘indirekte Sterbehilfe’, as well as ‘passive Sterbehilfe’ in the case of a valid and documented advance decision taken by the patient. ‘Aktive Sterbehilfe’ is illegal, and when it comes to ‘Beihilfe zur Selbstötung’, the law is the least clear. The newly appointed Federal Minister of Health, Hermann Gröhe (CDU), announced that his main goal in the revision of the law is to make sure no one can pursue any kinds of organised interest in helping others to die (this would include both commercial and charitable organisations). In this, he goes further than former Federal Minister of Justice Sabine Leutheusser-Schnarrenberger (FDP) who had suggested to make sure no commercial interests could be followed. Whereas other European countries have taken a liberal path (besides Belgium, think e.g. Luxembourg, the Netherlands), we notice that Germany’s legislation, for now and the foreseeable future, is much more restrictive.
My interest in the debate can partly be explained with my doctoral work-in-progress on autobiographical illness writing in contemporary German literature. On August 26th, 2013, Wolfgang Herrndorf, an author whose online blog about his life with a brain tumour I was following and will work on this year, shot himself, making use of what he called his exit strategy – a gun acquired after learning of his diagnosis in 2010. But of course the topic of Sterbehilfe involves us all, as the journalist and presenter Günther Jauch (in his chat-show of the same name) rightly pointed out on 19th January 2014. The hour-long discussion that developed among the invited guests Udo Reiter, Franz Müntefering, Petra Bahr, and Uwe-Christian Arnold was in large parts sophisticated and serious. It revolved around key words such as dignity, autonomy, quality of life, and the tricky question of what counts as Sterbehilfe, and what doesn’t. What didn’t emerge from the discussion were concrete demands directed towards political decision makers; perhaps unsurprisingly, as the discussants couldn’t bring themselves to any kind of agreement.
A point I was very glad to see made was that of people’s ‘Nützlichkeitserwägungen’ (trans.: ‘utilitarian considerations’) of themselves that Müntefering addressed; in other words, the highly concerning fact that someone may be driven into a decision for an early, assisted death through believing to be a burden to their family, monetary or otherwise. This aspect must come out clearer in future debates: Internalised discrimination is a key problematic here, and no matter if one is pro or contra Sterbehilfe, one must consider the powerful effect that an ableist, ageist society has on each individual’s ostensibly independent decision. Free will just isn’t the whole story. But one’s wish and circumstances equally should not be ignored. It’s heart-breaking to know that Herrndorf had to die all by himself, and probably died a much more painful death than he would have had in, for instance, Belgium, where he could have gone in the presence of friends and family, with much less secrecy.
It’s a fine line we’re walking, and any new legislation will have to be very carefully worded, written with as many different scenarios in mind as possible. Both in public and in private, more open conversations about Sterbehilfe are necessary in the face of this extraordinarily difficult task.
 Translate as ‘indirect euthanasia’. In the case of indirect assisted dying, a doctor may slowly increase one’s dose of painkillers because the patient has asked for it; these primarily take away the pain the person is in, and only secondarily shorten his/her life.
 Translate as ‘passive euthanasia’. This is what happens when life support measures are stopped.
 Translate as ‘active euthanasia’; occurs when someone actively injects lethal medication. Illegal in Germany, as in Britain, even when the patient has asked for it.
 Translate as ‘aid in committing suicide’; e.g. acquiring painkillers on the person’s behalf and placing them in that person’s hand.