What is assisted suicide?
At the assisted suicide, also known as assisted suicide or assisted dying, is when a person who wishes to die receives support from a third party in committing suicide. Unlike active euthanasia, the person concerned carries out the decisive act themselves – for example, by taking a lethal drug provided by a doctor or an assisted dying organisation.
This form of euthanasia differs fundamentally from other forms and is subject to Germany special legal framework conditions.
Current legal situation in Germany
The Federal Constitutional Court ruling of 2020
A landmark ruling fundamentally changed the legal situation: on 26 February 2020, the Federal Constitutional Court declared Section 217 of the German Criminal Code (StGB) to be unconstitutional. This section had made the commercial promotion of suicide a criminal offence.
The judges in Karlsruhe ruled that the general right to privacy includes the right to self-determined death. This right includes the freedom to take one’s own life with the voluntary assistance of a third party, regardless of age or medical condition.
Basic principles of the current regulation
Since the ruling, the following applies in Germany:
Assisted suicide is fundamentally not punishable by law., provided that the person wishing to die carries out the act independently and of their own free will. Assisting suicide is not a criminal offence.
Active euthanasia remains prohibitedThe direct killing of a person by administering lethal substances remains a criminal offence under Section 216 of the Criminal Code and is punishable as „killing on demand“ with a prison sentence of six months to five years.
No one is obliged to assist in suicideNeither doctors nor other persons may be compelled to assist in assisted suicide.
The legal grey area
Despite the 2020 ruling, assisted suicide remains in a legal grey area. The Bundestag has not yet passed any new legislation that clearly regulates access to assisted suicide.
Two legislative initiatives failed in July 2023:
- A more liberal draft by Katrin Helling-Plahr’s group
- A more restrictive draft by Lars Castellucci’s group
The lack of legal regulation leads to uncertainty for all parties involved – both for people who wish to die and for doctors and euthanasia organisations.
Medical assisted suicide
Professional legal situation
Following the ruling by the Federal Constitutional Court, the 124th German Medical Assembly in 2021 lifted the professional ban on medically assisted suicide. However, the German Medical Association emphasises that assisting in suicide is not a medical task.
Doctors may assist in suicide, but are not obliged to do so. The medical code of conduct continues to primarily encompass the duty to preserve life, protect health, alleviate suffering and accompany the dying.
Challenges in practice
The practice of medically assisted suicide poses considerable challenges:
Uncertain legal situationTwo doctors were convicted of manslaughter in 2024 after assisting mentally ill patients in committing suicide. These cases highlight the legal uncertainty under which medical professionals operate.
Lack of guidelinesMedical associations are working on guidelines to provide doctors with guidance on how to deal with suicide requests. In May 2024, the German Society for General Medicine published recommendations for general practitioners.
Examination of freedom of responsibilityA key challenge is determining whether the decision to commit suicide is truly free, serious and permanent.
Euthanasia organisations in Germany
Legal activity since 2020
Since the ruling by the Federal Constitutional Court, euthanasia associations can once again operate legally in Germany. The best-known organisations are:
- German Society for Humane Dying (DGHS)
- Euthanasia in Germany
- Dignitas (Swiss organisation operating in Germany)
Increasing utilisation
The number of assisted suicides with the support of euthanasia organisations has risen significantly since 2020. The DGHS recorded:
- 229 assisted suicides in 2022
- 418 in 2023
- 623 in 2024
In 2024, a total of around 1,000 people in Germany took their own lives with the help of assisted suicide organisations – and the trend is rising.
Approach of the organisations
As there are no legal requirements, each organisation establishes its own procedures. These usually include:
- Several counselling sessions
- Examination of freedom of responsibility
- Waiting periods to ensure the permanence of the desire to die
- Medical assessment
Distinguishing between different forms of euthanasia
In order to understand the legal classification, it is important to distinguish between the different forms of euthanasia:
Passive euthanasia
Withdrawal or discontinuation of life-prolonging measures in accordance with the patient’s wishes. Permitted in Germany, if a living will exists or the patient’s current wishes are known.
Indirect euthanasia
Administration of pain-relieving medication, which can have the unintended side effect of hastening death. Permitted in Germany, if the main objective is pain relief (principle of dual action).
Active euthanasia
The deliberate causing of death by administering lethal substances. Prohibited in Germany in accordance with Section 216 of the Criminal Code, even if expressly requested by the patient.
Assisted suicide
Provision of lethal substances that the patient takes themselves. Not punishable in Germany, as long as the act is carried out by the person wishing to die themselves.
Future developments
Discussion about legal regulation
The political debate on new legislation is ongoing. A cross-party group in the Bundestag has taken up the issue again, but there is no concrete timetable.
Proponents of statutory regulation argue that it would create legal certainty for:
- People wishing to die and their access to assisted suicide
- Doctors who wish to assist patients in committing suicide
- Clear protection standards against abuse
Opponents emphasise that the existing legal situation is sufficient and that additional regulations could restrict self-determination.
National suicide prevention strategy
Parallel to the discussion on assisted suicide, the Federal Government presented a National Suicide Prevention Strategy in April 2024. This was followed in November 2024 by a draft bill for a Suicide Prevention Act.
These initiatives aim to:
- Strengthening suicide prevention
- Expanding palliative and hospice care
- Providing better support to people in crisis situations
- Improving information about alternatives to suicide
Palliative care as an alternative
An important aspect of the debate concerns the role of palliative care. Many wishes to die arise from fear of unbearable pain or the loss of autonomy and dignity.
Modern palliative medicine offers comprehensive options for:
- pain relief
- symptom control
- Psychosocial support
- Spiritual support
Statutory health insurance funds finance various palliative care structures, including:
- Specialised outpatient palliative care (SAPV)
- Inpatient hospices
- Palliative care units in hospitals
Access to high-quality palliative care can significantly reduce or even eliminate the desire for assisted suicide in many cases.
International perspective
Regulations on assisted suicide vary considerably from country to country:
SwitzerlandAssisted suicide is permitted as long as there are no selfish motives. Organisations such as Dignitas and Exit also offer their services to German citizens.
Netherlands, Belgium, LuxembourgActive euthanasia is legal under strict conditions.
Spain: Since 2021, euthanasia has been permitted under certain conditions.
AustriaSince 2022, assisted suicide has been permitted under certain conditions after the Constitutional Court lifted the previous ban.
Living will and advance healthcare directive
Anyone who wishes to record their wishes regarding euthanasia and medical treatment at the end of life can do so in a living will. In a free text field, you can also formulate your personal views on assisted suicide.
A living will can significantly ease the burden on relatives and treating physicians, as the patient’s wishes are clearly documented. It should be updated regularly and, ideally, discussed with relatives and the family doctor.
Help available for suicidal thoughts
If you are struggling with suicidal thoughts or are in a personal crisis, free and anonymous help is available around the clock:
telephone counselling:
- 0800 111 0 111
- 0800 111 0 222
- www.telefonseelsorge.de (also via email and chat)
Further support:
- General practitioners and specialists in psychiatry and psychotherapy
- Psychosocial counselling centres
- Crisis services provided by local authorities and municipalities
- self-help groups
Summary
The legal situation regarding assisted suicide in Germany has changed fundamentally since 2020. The Federal Constitutional Court has confirmed the right to self-determined dying and declared the commercial promotion of suicide to be permissible.
Nevertheless, considerable uncertainties remain:
- There is still no legal regulation
- Doctors operate in a legal grey area
- Euthanasia organisations set their own standards
- Assessing free responsibility remains challenging
Parallel to the discussion on assisted suicide, suicide prevention is being strengthened and the expansion of palliative care services is being promoted. These developments show that society is seeking a balanced approach to self-determined dying – between respect for individual autonomy and the protection of vulnerable people.
This article provides information about the legal and social situation regarding assisted suicide in Germany. It is not a substitute for individual advice from doctors, lawyers or pastoral carers. If you are experiencing acute suicidal thoughts, please contact a telephone counselling service or emergency medical service immediately.
