Internal correspondence: "stain" and "dilemma" – medical authority criticizes Spahn's anti-euthanasia directive – political

The instruction of the Federal Minister of Health, Jens Spahn (CDU), to reject the applications for drug release for euthanasia has brought the Federal Institute for Drugs and Medicines. medical instruments (BfArM) according to his own statements in a "dilemma". The Bonn authority, which is under the authority of the minister, feels that the tedious review of the requests of the dying patients is insignificant and takes time, if the result is to be clear anyway. This criticism comes from an internal letter from the head of the Bundesopiumstelle BfArM to the authorities, which was to be addressed to the Tagesspiegel in accordance with the Freedom of Information Act (IFG). The letter states: "It does not matter whether the BfArM examines the content and justifies refusal decisions: decisions will henceforth be subject to the condition that, instead of an appropriate substantive examination, they have been published in accordance with the instructions."

In March 2017, the Federal Administrative Court ultimately ruled that critically ill people living in an unbearable suffering situation could obtain a permit from BfArM allowing them to acquire lethal narcotics in order to commit suicide. The Federal Ministry of Health (BMG) refuses to enforce the controversial judgment as it forces the state to assist in suicide. As a result, at the end of June of last year, Spahn instructed to refuse requests. Since the decision, BfArM has received 127 requests and 93 have already been rejected. 24 patients died during the waiting period.

Although the BfArM states externally, it approves the requests "after careful consideration on a case-by-case basis taking into account the individual circumstances", but it is clear from the documents made public that the officials see themselves under the "Spahn Decree" before a " dilemma in the processing of applications ". It seems "unreasonable" to consider the content of applications "if the outcome of the decision is already known before the processing of the application".

Nevertheless, BfArM adheres to the elaborate test procedure. Applicants are regularly invited to submit medical reports and patient data. In the end, the safe rejection follows. In addition, all the objections to the decisions are rejected, a total of 18. Until now, the persons concerned are brought to justice.

The decision of the Federal Constitutional Court to rule on complaints against the Criminal Code, at para. 217, could also determine whether she should remain in the treatment of seriously ill people. The provision prohibits the "professional" promotion of suicide. Patients find that their right to self-determination has been violated and that doctors have lost their professional freedom. At the April trial, constitutional judges were skeptical about the offense. The expected judgment for the fall could mark a change. Spahn has sent observers to Karlsruhe to be tried but refuses to report to parliament and the press. "The federal government does not comment on ongoing court proceedings," he said on request. The Tagesspiegel has filed an urgent petition with the Cologne Administrative Court to require the Ministry of Health to disclose it.

It is also possible that a judgment of the Federal Court of Justice (BGH) expected Wednesday would contribute to a liberalization of the treatment of euthanasia. The court found two cases in which doctors from Berlin and Hamburg had accompanied patients after taking lethal drugs, without taking any rescue measures. The regional courts of Berlin and Hamburg have released the doctors. Moreover, the prosecutors have filed a review, the cases are now in the 5th Criminal Division of the BGH in Leipzig. Active euthanasia, that is killing on demand, is punishable in Germany. On the other hand, a medical interruption of the treatment is authorized and can even be obligatory if it is in accordance with the express wishes of the dying persons. The legal situation is not clear if doctors accompany their patients to suicide or provide their help. If they do so repeatedly, this may also include a suicide assistance "in the manner of a company", punishable.