Should Germany shake off its scruples about assisted suicide? Der Spiegel pursued this sensitive question in a recent interview with Dr Michael de Ridder, an emergency medicine specialist who is also the chairman of the Hans Joachim and Käthe Stein Foundation for Palliative Medicine. His book, he released the book "Wie wollen wir sterben? Ein ärztliches Plädoyer für eine neue Sterbekultur in Zeiten der Hochleistungsmedezin," or "How Do We Want To Die? A Doctor's Plea for a New Culture of Dying and Death, in an Era of High Tech Medicine" was released last month in Germany.

Dr de Ridder believes that doctors are afraid to let people die and keep them alive in undignified states simply because they can. “With palliative medicine, we now have the ability to make death happen the way people want it to: Peacefully. But all too often we work against that principle and turn death into a horrible experience for many,” he told Der Spiegel.

It’s difficult to tell from the interview whether he distinguishes between palliative care and terminal sedation. But the interview takes an interesting turn when he discusses medical ethics:

Protocols should replace clinical judgement: “It isn't about morals. It's about empiricism. You could say, for example: If a treatment was not successful the first 100 times, it should not be used for the 101st time.”

Doctors have a higher duty than ethics: “I am convinced that there are situations in which it isn't just ethically justified, but in which I, as a doctor, have a duty to do this. Situations in which I am called upon to relieve the suffering of someone who is severely ill, and in a hopeless situation -- and to conduct this in the manner in which the patient wants. In this sense, I see assisted suicide as a kind of palliative measure, albeit a very extreme one.”

A debate on assisted suicide is needed in Germany: “For years, the German Medical Association has had a de-facto ban on thinking or speaking about this issue. But as doctors we need an open debate on physician-assisted suicide and the problems that arise around the administration of palliative care.” ~ Der Spiegel, Mar 26