Reproductive self-determination and regulation of termination of pregnancy in Germany: current controversies and developments

  • In Germany, efforts to reform current legislation governing access to termination of pregnancy (TOP) have recently gained momentum. In 2023, the German Federal Government appointed a ‘Commission on Reproductive Self-Determination and Reproductive Medicine’, which released recommendations to revise legislation of TOP in April 2024. Currently, TOP is unlawful under the German Criminal Code, with exemptions from punishment for TOP performed within the first 12 weeks of pregnancy following mandatory counselling. Additional exemptions exist in case of criminological or medical-social indications. The Commission report recommends the decriminalisation of early-stage TOP and potential abolition of the mandatory counselling requirement. It further recommends a revision of the medical-social indication, due to a lack of clarity in its interpretation. This indication allows for TOP beyond 12 weeks of pregnancy, where there is danger to the pregnant woman’s life or health. This paperIn Germany, efforts to reform current legislation governing access to termination of pregnancy (TOP) have recently gained momentum. In 2023, the German Federal Government appointed a ‘Commission on Reproductive Self-Determination and Reproductive Medicine’, which released recommendations to revise legislation of TOP in April 2024. Currently, TOP is unlawful under the German Criminal Code, with exemptions from punishment for TOP performed within the first 12 weeks of pregnancy following mandatory counselling. Additional exemptions exist in case of criminological or medical-social indications. The Commission report recommends the decriminalisation of early-stage TOP and potential abolition of the mandatory counselling requirement. It further recommends a revision of the medical-social indication, due to a lack of clarity in its interpretation. This indication allows for TOP beyond 12 weeks of pregnancy, where there is danger to the pregnant woman’s life or health. This paper provides an overview of Germany’s current TOP regulation and the Commission’s recommendations, with a particular focus on the ethical and legal challenges posed by the application of the current medical-social indication in cases of fetal anomalies. We argue that while legislative clarity is important, maintaining a broad interpretation of the medical-social indication is crucial to prevent undue restrictions on TOP access at later gestations. The Commission report represents a promising step forward in changes for TOP legislation in Germany, and we welcome its call for legal reform. However, given the outcome of the recent federal election in February 2025, it is unlikely that the revision of TOP legislation will be part of the new government’s agenda.show moreshow less

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Metadaten
Author:Christin Hempeler, Hilary Bowman-Smart, Tamar Nov-KlaimanORCiDGND, Ruth HornORCiDGND
URN:urn:nbn:de:bvb:384-opus4-1214179
Frontdoor URLhttps://opus.bibliothek.uni-augsburg.de/opus4/121417
ISSN:0306-6800OPAC
ISSN:1473-4257OPAC
Parent Title (English):Journal of Medical Ethics
Publisher:BMJ
Place of publication:London
Type:Article
Language:English
Year of first Publication:2026
Publishing Institution:Universität Augsburg
Release Date:2025/04/11
Volume:52
Issue:2
First Page:71
Last Page:76
DOI:https://doi.org/10.1136/jme-2024-110457
Institutes:Medizinische Fakultät
Medizinische Fakultät / Professur für Ethik der Medizin
Nachhaltigkeitsziele
Nachhaltigkeitsziele / Ziel 5 - Geschlechtergleichheit
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Licence (German):CC-BY-NC 4.0: Creative Commons: Namensnennung - Nicht kommerziell