Demand for strengthening the suicide prevention strategy
In the context of the debate around the licitness and legal regulation of euthanasia, the demand for a parallel, partly even prioritised strengthening of structures of the suicide prevention strategy is frequently being expressed by different parties. Also, the here presented position of the German Ethics Council recommends a strengthening of suicide prevention.
Strengthening and priority of suicide prevention
In the debate around the legal regulation of assisted suicide, the importance and priority of an extensive expansion of suicide prevention is being emphasised on part of the medical profession. In 2023, the German Bundestag agreed with majority, across parliamentary groups, to financially support existing structures and services of suicide prevention. Additionally, an extensive strategy for a sustainable expansion of suicide prevention in Germany should be developed until mid-2024. The legal regulation of euthanasia is also of importance for suicide prevention. As stated by Dr. Klaus Reinhardt, President of the German Medical Association, such regulation is necessary to end the current, disorganised situation. Reinhardt continued, that a law for assisted suicide however has to be associated with a preceding strengthening of suicide prevention as only then one will do justice of the right of self-determination and the interest in protection of those concerned evenly.
In the course of the debate around the new regulation in 2022, the German Association for Palliative Medicine and the German Hospice and Palliative Association published key points for a legal embedding of suicide prevention („Eckpunkte für eine gesetzliche Verankerung der Suizidprävention“). They emphasize that, in addition to regulating assistance for suicide, the legislator's task is above all to develop a protection concept for people with suicidal thoughts and to ensure that this concept is implemented. Supportive help for humans in crisis as well as hospice work and palliative care services should be more easily accessible than assisted suicide. This priority of prevention should withal be independent of age and disease.
Deutscher Hospiz- und PalliativVerband e.V., Deutsche Gesellschaft für Palliativmedizin, Deutsche Gesellschaft für Suizidprävention, Nationales Suizidpräventionsprogramm (2022): Eckpunkte für eine gesetzliche Verankerung der Suizidprävention (01.06.2022). Online Version (German)
Antrag 20/7630: Suizidprävention stärken (05.07.2023). Online Version (German)
Bundesärztekammer (2024): Pressemitteilung vom 17.01.2024: 2024 darf kein verlorenes Jahr für die Suizidprävention in Deutschland werden. Online Version (German)
Opinion of the German Ethics Council
The German Ethics Council already published multiple Ad hoc recommendations on the topic of assisted suicide, notably in 2014 and 2017. On the occasion of the decision of February 26, 2020, of the Federal Constitutional Court, the German Ethics Council published 2022 an extensive opinion on the topic of suicide, that follows its objective in a threefold regard: First, an appropriate awareness for the range and complexity of suicidal tendencies should be created, second, the internal and external requirements for autonomous decisions for suicide should be determined, and third, the responsibilities of different agents should be localised. In this opinion of 2022 however, the legal regulation is not being taken into focus. Instead suicide prevention is being discussed, which is especially linked to the prevention of life situations in which humans feel compelled to end a, at least subjectively experienced as unendurable life situation through suicide. Suicide prevention contains various interventions and responsibilities of different agents on different levels of intervention ("multi-actor responsibility"). In their opinion, the German Ethics Counsel recommends strengthening the structures of suicide prevention as well as extending hospice work and palliative care.
Deutscher Ethikrat (2022): Opinion: Suicide– Responsibility, Prevention and Autonomy. Online Version (German); Executive summary (English)