# Critical Medical Ethics as an Approach to the Debate About Assisted Suicide by the Example of Germany

## TL;DR

The paper examines if the autonomy-only approach to assisted suicide in Germany truly supports personal freedom or hides deeper ethical issues.

## Contribution

It introduces a critical medical ethics framework using Critical Theory to evaluate autonomy in assisted suicide debates.

## Key findings

- The autonomy-only approach may not fully support true personal freedom in practice.
- Critical Theory provides tools to uncover social contradictions in ethical models.
- Ethical deliberations should avoid both naive autonomy and paternalism.

## Abstract

Recent literature has seen a growing endorsement of the so‐called autonomy‐only approach to assisted dying, which rejects suffering as a necessary criterion for access. Proponents argue that this model is most suitable to safeguard individuals against value‐based judgments of healthcare professionals about whether their lives are still worth living when it comes to decisions on assisted dying. In this paper, I challenge the assumption that the autonomy‐only approach successfully avoids the shortcomings of a joint view at assisted dying that also relies on beneficence‐based criteria. Based on the example of Germany, a country that follows the autonomy‐only approach towards assisted suicide, I contend that, despite its emphasis on personal freedom, this approach may in practice not truly serve the ideal of autonomy as it claims. Referring to critical medical ethics, I argue that Critical Theory offers the epistemic tools needed to identify underlying social contradictions and to evaluate the concept of autonomy in relation to its real‐world application. Drawing on the work of Herbert Marcuse, I highlight the importance of considering how individual needs are shaped and mediated by social conditions in ethical deliberations on assisted dying. I conclude that ethical considerations have to avoid both submitting to short‐sighted conceptions of autonomy and taking a paternalistic stance that dismisses individual pledges for assisted suicide if they disagree with supposedly objective reasons.