Evidence map›Paper›PMID 42711691›Full record

ArticleBMC medical ethics2026

Development, implementation, and evaluation of a registry for the documentation and analysis of assisted suicide in Germany (RegAS) - study protocol.

Kerstin Kremeike, Farina Hodiamont, Christina Koenes, Katharina König, Ute Lewitzka, Maria Meinhardt, Jonas Wifek, Irene Schmidtmann, Veronika Dunkl, Alina Kasdorf and 9 more

Abstract read
In one paragraph

Article in BMC medical ethics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors.

Kerstin KremeikeDepartment of Palliative Medicine, LMU University Hospital, LMU Medizin, Ludwig-Maximilians-Universität München, Marchioninistraße 15, 81377, Munich, Germany. kerstin.kremeike@med.uni-muenchen.de.ORCID https://orcid.org/0000-0003-4316-2379
Farina HodiamontDepartment of Palliative Medicine, LMU University Hospital, LMU Medizin, Ludwig-Maximilians-Universität München, Marchioninistraße 15, 81377, Munich, Germany.
Christina KoenesDepartment of Palliative Medicine, LMU University Hospital, LMU Medizin, Ludwig-Maximilians-Universität München, Marchioninistraße 15, 81377, Munich, Germany.
Katharina KönigWerner-Felber-Institute for Suicide Prevention and Interdisciplinary Research in Health Care, Dresden, Germany.
Ute LewitzkaDepartment of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe-University of Frankfurt, Frankfurt, Germany.
Maria MeinhardtWerner-Felber-Institute for Suicide Prevention and Interdisciplinary Research in Health Care, Dresden, Germany.
Jonas WifekWerner-Felber-Institute for Suicide Prevention and Interdisciplinary Research in Health Care, Dresden, Germany.
Irene SchmidtmannInstitute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), Johannes Gutenberg University Mainz, Mainz, Germany.
Veronika DunklDepartment of Palliative Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany.
Alina KasdorfDepartment of Palliative Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany.
Raymond VoltzDepartment of Palliative Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany.
Martin NeukirchenInterdisciplinary Centre of Palliative Care, Medical Faculty, University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.
Jacqueline SchwartzInterdisciplinary Centre of Palliative Care, Medical Faculty, University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.
Marc StefaniakInterdisciplinary Centre of Palliative Care, Medical Faculty, University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.
Barbara SchneiderDepartment of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe-University of Frankfurt, Frankfurt, Germany.
Reinhard LindnerNational Suicide Prevention Programme (NaSPro), Kassel, Germany.
Georg FiedlerGerman Academy for Suicide Prevention (Deutsche Akademie Für Suizidprävention, DASP), Kassel, Germany.
Claudia BauseweinDepartment of Palliative Medicine, LMU University Hospital, LMU Medizin, Ludwig-Maximilians-Universität München, Marchioninistraße 15, 81377, Munich, Germany.
RegAS Study Group

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn 2020, the German Federal Constitutional Court declared the criminal prohibition of assisted suicide as unconstitutional, thereby abolishing previous restrictions. Since then, requests and cases have increased steadily. To ensure transparency and traceability of national assisted suicide practices, systematic and reliable data are required. However, no comprehensive registry currently exists to document and analyze assisted suicide cases in Germany, resulting in a significant data gap for epidemiology, health reporting, and healthcare development. The development, implementation, and evaluation of such a registry is essential to better understand current practices, identify challenges, and improve prevention and support strategies.

methodsIterative, mixed-methods, design-based implementation study with five work packages: 1. conceptual, ethical, and legal development of registry content through a scoping review and a group Delphi process; 2. establishment of the legal, ethical, and technical framework of the registry using an iterative, design-based approach; 3. evaluating and refining the registry through a formative mixed-methods design combining quantitative user surveys and web analytics with qualitative think-aloud and retrospective interviews; 4. exploring barriers to the adoption, continuation, and use of the registry through quantitative surveys and in-depth qualitative interviews with potential users; 5. strategic development, dissemination, and integration of the registry within existing healthcare and suicide prevention structures. The study involves expert consultations and stakeholder engagement and is conducted by a multidisciplinary consortium of palliative care and suicide prevention experts in Germany. DISCUSSION: The establishment of a permanent registry for assisted suicide could substantially improve transparency and empirical knowledge in a highly sensitive and ethically complex field. Systematic documentation may help identify needs, vulnerabilities, and structural challenges faced by individuals considering assisted suicide. In the long term, the findings derived from the registry are expected to contribute to the development of targeted support services in Germany. The study results may also provide valuable insights for other countries facing comparable ethical, legal, and regulatory challenges.

trial registrationRegistered on 25 October 2025 in the BQS (Institute for Quality and Patient Safety) registry, No. 2020467 and on 29 April 2026 in the German Clinical Trials Register (DRKS), No. DRKS00040174.

Indexed as

DocumentationRegistriesSuicide, AssistedGermanyHumansResearch DesignAssisted suicideGermany(health) care researchImplementation researchMedical aid in dyingMedical ethicsMixed-methods studyRegistrySuicide prevention

Identifiers

PMID42711691
PMCPMC13551708

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.