Correspondence
Conclusions not Correct
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In a selective review of the literature, the authors conclude that in Belgium, as in other countries with legally regulated access to assisted suicide and euthanasia (killing on request), no slippery slope (mistakenly translated as “Dammbruch“ in German) towards an increase in this form of dying exists (1).
We do not agree with this assessment. The question of the consequences of legally facilitated access to assisted suicide and killing on request requires a much more differentiated approach than is taken in this paper. For example, a “slippery slope” may also mean that psychosocial desensitization is promoted, in which dying is understood as an individual decision and not as a complex process in dependency relationships with multiple contributing factors (2). An above-average number of women, persons with higher levels of education, and depressed and anxious persons are found among those considering assisted suicide (3). Unchallenged gender stereotypes and treatable mental health problems need to be addressed. There is need for a more in-depth analysis of the continuous increase in euthanasia in countries with such legislation (for example, the Netherlands) or the different application in Belgian regions (Flanders, Wallonia) despite the same legislation.
The current attitude of the German population towards assisted suicide was determined in a representative population survey. According to the survey, there is consent to assisted suicide primarily for terminally ill people, but not for younger or older healthy people experiencing life crisis (4). The study is to be repeated at the end of 2023 in order to identify possible effects of the current debate on a legal regulation on public opinion in Germany.
DOI: 10.3238/arztebl.m2023.0070
Prof. Dr. med. Reinhard Lindner
Universität Kassel, Institut für Sozialwesen
Fachbereich Humanwissenschaften
Kassel, Germany
Reinhard.Lindner@uni-kassel.de
Prof. Dr. med. Claudia Bausewein, Munich, Germany
Dipl. Psych. Georg Fiedler, Hamburg, Germany
Prof. Dr. med. Lukas Radbruch, Bonn, Germany
Prof. Dr. med. Barbara Schneider, Cologne, Germany
Prof. Dr. med. Raymond Voltz, Cologne, Germany
Conflict of interest
RL is member of the executive management of the National Suicide Prevention Program for Germany (NaSPro, Nationales Suizidpräventionsprogramm für Deutschland).
CB is President of the German Association for Palliative Medicine (DGP, Deutsche Gesellschaft für Palliativmedizin).
GF is an executive board member of the German Academy for Suicide Prevention (DASP, Deutsche Akademie für Suizidprävention).
LR is Chair of the Board of Directors of the International Association of Hospice and Palliative Care.
BS is member of the executive board of the National Suicide Prevention Program for Germany (NaSPro, Nationales Suizidpräventionsprogramm für Deutschland).
RV received funding for research projects to the Center for Palliative Medicine from the German Federal Ministry of Education and Research (BMBF) and the German Federal Ministry for Family Affairs, Senior Citizens, Women, and Youth (BMFSFJ).
| 1. | Mroz S, Deliens L, Cohen J, Chambaere K: Developments under assisted dying legislation—the experience in Belgium and other countries. Dtsch Arztebl Int 2022; 119: 829–35 VOLLTEXT |
| 2. | Klesse R, Teising M, Lewitzka U, et al.: Assistierter Suizid und Autonomie – ein Widerspruch? Das Konzept der »freien« Entscheidung zum Suizid im Lichte von anthropologischen, entwicklungspsychologischen und psychotherapeutisch-psychiatrischen Befunden. Psychosozial 2022; 45: 3–32 CrossRef |
| 3. | Castelli Dransart DA, Lapierre S, Erlangsen A, et al.: A systematic review of older adults’ request for or attitude toward euthanasia or assisted-suicide. Aging Ment Health 2019; 25: 420–30 CrossRef MEDLINE |
| 4. | Fiedler, G, Drinkmann A, Schwab F, Lindner R: Suizidprävention und Suizidassistenz. Suizidprophylaxe 2022; 49: 100–2. |
