End-of-life decisions without medical assistance in Germany

In contrast to the situation in the Netherlands and Belgium, as well as in the US State of Oregon, but comparable to most European countries, no euthanasia law exists in Germany. Active euthanasia is punishable by Criminal Law and is also prohibited by Professional Law. Two cases of a 59-year-old woman with locked-in syndrome and a 7-year-old boy in a stable vegetative state with convulsions after near-drowning, demonstrate that unbearable suffering may lead relatives (the husband and the grandmother as custodian, respectively) to killing. Both custodians were punished for killing on request and manslaughter, respectively. In neither case had medical doctors been involved. Palliative (terminal) sedation followed by death of the patient as an acceptable side-effect may have been a justifiable medical decision to end the life of the patients.