By Dr. Thomas Sitte
Dr. Thomas Sitte begins with the death of Franz Kafka and the pain-relieving injection that likely hastened respiratory arrest. The example raises a difficult question: when does medical help at the end of life become the active bringing about of death?
The article then presents the perspective of a fictionalized but personally experienced case. A young woman with a progressive neurological disease knows that her body will become immobile. She fears being kept alive against her written will by modern medicine and by relatives who cannot accept her decision. She asks a trusted physician to help her die.
The patient describes the loss of independence, the humiliation of needing intimate care, feeding tubes, urinary catheters and the fear of a life maintained by technology. She trusts one doctor enough to ask him for active euthanasia. He understands her despair, but finally says no. He cannot kill her.
Sitte does not present that refusal as an easy answer. The patient's tears and anger remain. Yet the article argues that the real task is to create genuine alternatives: no one may be kept alive against their will, and everyone has the right to relief of suffering. Unwanted life-prolonging treatment and the denial of necessary symptom relief can both be violations of bodily integrity.
In the concrete case, Sitte argues, it would have been possible to allow the patient to die according to her wishes without killing her. Breathlessness and other distressing symptoms can be relieved professionally. Nobody today has to suffocate. Dying is a natural process; the task is not to intervene excessively, but to relieve burdensome symptoms.
The article concludes that Germany has the medical and economic means to provide good palliative care for every citizen. Instead of making access to assisted suicide easier, energy should be directed toward comprehensive general and specialized palliative care and toward public education that gives people confidence that they can be well accompanied while dying.
