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.

Publication of a suicide prevention strategy by the BMG in April 2024

In April 2024, the Federal Ministry of Health published the required, comprehensive strategy for the sustainable expansion of suicide prevention in Germany.
The suicide prevention strategy aims to overcome the social taboo surrounding subjects such as death and loneliness, to raise social awareness of suicide and its preventability and to destigmatize mental illnesses.

To this end, the report presents the following measures and recommendations in the form of three fields of action: Health literacy and empowerment form the first field of action, which aims to organize access to information and help services more low-threshold and comprehensive for those affected, relatives and professionals. In addition, training courses are to be developed for healthcare and nursing professionals to raise awareness and on dealing with suicidal tendencies. The establishment of a nationwide psychosocial crisis service and the expansion, further development and networking of existing telephone and online counseling services form the second field of action. The third field of action provides for the establishment of a national competence and coordination center to network the numerous state and non-state actors, including those from crisis services and health, as well as to ensure a scientific basis for suicide prevention.

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.