By Hilary White

KARLSRUHE, Germany, June 3, 2010 ( – Germany’s Federal Court of Justice (Bundesgerichtshof) is expected to rule this month on whether the removal of artificially administered food and water constitutes murder or is simply the cessation of “medical treatment.”

The case surrounds an attempt to euthanise “Erika K,” who had been comatose since a cerebral hemorrhage in 2002. The woman’s daughter claimed her mother had previously expressed a desire not to have her life artificially prolonged and asked nursing home staff to discontinue her mother’s “artificial diet.” The nursing home initially agreed, but then backed down.

The daughter, known as “Elke G” in court, said that following the advice of her lawyer, Wolfgang Putz, she used scissors to cut the gastric tube from her mother’s abdominal wall. Upon discovery, nurses inserted a new feeding tube and called the police.

Although Erika K died shortly after of unrelated causes, the daughter and her lawyer were indicted for attempted manslaughter. Elke G. was acquitted, but Putz received a nine month suspended sentence.

The appeal was heard on Wednesday in the Second Criminal Division of the Federal Court in Karlsruhe, with prosecutors asking for a tougher sentence. A ruling is expected on June 25.

Putz’s lawyer argued that the use of a gastric tube is “forced treatment” that the daughter had a right to terminate according to the known will of her mother. No one should be treated against their will, he said, and although the cutting of the tube was an active interference, the daughter had merely restored her mother’s “natural dying process.”

Commenting on the case, the German Hospice Foundation said that patients have a right to care in nursing homes, and criticised Putz for his “wild-west” action.

The utilitarian and eugenic arguments commonly employed by the international euthanasia and assisted suicide movement touch a particularly sensitive nerve in Germany, where the Nazi regime introduced the Aktion T4 euthanasia programme in the 1930s. While so-called “mercy killing” or killing at the request of the victim is unambiguously a criminal act in Germany, suicide is not outlawed, and “assisting” a suicide can be a legal grey area.

Under the current criminal code, a conviction for homicide is possible if a suicidal person is shown to have been acting while under duress or without free will. The law recognizes three criteria that may negate free will: if the person is under 14, if the person has “one of the mental diseases” listed in the criminal code, or if the person is acting under a “state of emergency.”

The law also stipulates that under certain conditions a person with legal responsibility for another, such as a physician, police officer or guardian, may be legally bound to prevent a suicide or else be subject to prosecution for homicide by omission.

The classification of artificially administered food and water as “medical treatment” has been a key tool of the euthanasia and assisted suicide campaign to allow patients who are not dying to be legally killed.

Death by dehydration has reportedly become a common practice in nursing homes and hospitals in Canada and Britain, with the latter introducing an official protocol, the Liverpool Care Pathway, that allows doctors to override the will of patients and family.

Read’s extensive coverage of this issue here.