Assistierte Suizide in München – eine Analyse vorliegender Gutachten

In three previous publications the authors presented first data on assisted suicides (AS) in Munich. In addition, the quality of expert reports on AS were examined.

All death certificates in Munich from January 1, 2020, to December 31, 2023, were examined for cases of AS. If the corresponding public prosecutor’s files contained expert reports, these cases of AS were anonymized and analyzed descriptively.

Psychiatric disorders with a potential impact on free will, such as depression, cognitive impairment, and dementia, were present in approximately 24%, 3% and 7% of cases, respectively. In less than half of these cases no psychiatric or psychological experts were appointed. In almost two thirds of the cases the expert, suicide assistant and postmortem examiner were the same person. Almost one fifth of the expert reports were classified by the authors merely as attestation. Only in about two thirds of the cases were alternatives to AS and the physical prerequisites for the suicide documented.

The free will required by the Federal Constitutional Court as a prerequisite for exemption from prosecution of AS, in the view of the authors includes: 1) competent assessment of the ability to give consent, 2) open-ended, comprehensive, early and, if necessary, interdisciplinary information about AS, 3) transparent preparation with separation of the roles of pretreatment and informing physician, expert, assisting physician and postmortem examiner and 4) sufficient reflection phases. An assessment of the qualification of the experts would be desirable. In any case, if there are indications of a lack of free will specialists in psychiatry should be involved. Expert reports should be standardized.