"I do not want to live any more and ask you to please consider helping me end it...". Judge Rolf Vogel has heard countless requests from convicts, but never one like. Mr. B., a sociologist from Michelsberg, 52 years old, is a murderer. He killed his wife. Experts have confirmed that he suffers from schizophrenia. At the hearing, fully composed, he told the judge: "I want to die. Help me."

Now the Federal Medical Association (BÄK) is calling openly for "a relaxation of the rules" relating to physician-assisted death, and one German doctor in three is ready to intervene to end the suffering of terminally ill patients who wish to die.

Ex-senator Kusch, who in 2006 paid for the defence of such ideas with his political career and his CDU membership card, can talk of an indirect victory. He has founded a public interest association called “Help to Die" and admits that he has used his invention – making sure, however, that he leaves the patient’s bedside at the critical moment in order to avoid the legal consequences of his act. Left alone, Kusch’s customers receive by automatic injection a lethal dose of potassium chloride.

6,400 euros, cremation included

The issue of medically assisted dying for the terminally ill and the elderly had already been broached some years earlier by Karsten Vilmar, the former head of BÄK, who preferred the term "socially acceptable death” to the term “euthanasia”. According to the current head of BÄK, Jörg-Dietrich Hoppe, it is clear that doctors should not be convicted or accused of unethical conduct for assisted suicide.

Hoppe rules out the active participation of physicians in the act of killing but calls for the legalisation of their role as advisers to people who are tired of life and as doctors who can prescribe appropriate medical facilities. Such assistance would fall, he says, strictly within the bounds of "medical conscience." His viewpoint is shared by nearly 74 percent of Germans, who want the active assistance of health professionals in euthanasia.

For the head of Caritas Germany, Peter Neher, getting a doctor’s assistance in order to die is unacceptable even if such help is passive. Graduates of medical schools do not take the Hippocratic oath in order to kill, Neher argues. Opponents of euthanasia also assert that the desire to commit suicide is one of the symptoms of depression, and as such is temporary and treatable, and that even those with severe disabilities rediscover the will to live if properly helped. The liberalisation of German legislation on assisted suicide is a matter of time, however, given the weight of opinion in its favour in the medical and legal spheres – even more so as European suicide "tourism" is booming.

Sir Edward Downes was once the BBC Philharmonic’s main conductor. His wife, Lady Joan Downes, 11 years younger, had been a ballet dancer. At 85, Sir Edward had lost his sight and hearing, and his wife had developed cancer. As euthanasia was against the law in Britain, Downes sought help from the Swiss organisation Dignitas. They were the first clients of Ludwig Minelli, a lawyer and the organisation’s founder. A villa overlooking picturesque Lake Pfäffikon, east of Zurich, awaits volunteers ready to commit suicide there. Although the price for such a service is not negligible (6,400 euros, cremation included), demand has quickly exceeded the technical capacities of this "entrepreneur".

Ease the finances of the health system

Euthanasia is legal in Switzerland. For possible inspections, however, those who carry out the euthanasia must produce a video recording demonstrating that the persons concerned have made the decision to die by themselves. Most Swiss people accept assisted dying, but there are also those who do not want their country’s landscape marred by a steady stream of funeral caravans from all over Europe.

However, recent detractors have lost their battle with the business of death. Faced with a steady increase in demand for such services, legislators and policymakers are increasingly being forced to give way. With legislation already in force since 2001, the Netherlands set the stage for euthanasia in Europe. The number of people who die on demand in Benelux is currently estimated at between 3,000 and 4,000 per year. To legalise assisted death, Luxembourg amended its constitution. Almost all the countries of western Europe tolerate passively-assisted dying.

For some, lurking behind this trend is a desire "to ease the finances of the health system." In the Netherlands, the instrumentalisation of death can now be symbolised by a single digit: 4. This is the average number of minutes required by physicians to make the decision to hasten death, while nearly a quarter of the killings were performed without the consent of the patient. The Guardian, which has looked into the 114 cases of British parties who went to Switzerland to commit suicide, found clear evidence that many of them had a chance to cure their illnesses and live in dignity.