They wanted the best for a twin – now they're in front of the Berlin district court for manslaughter in the other twin.
The senior doctor Babett R. and the then chief professor, Professor Klaus V., made a caesarean section in July 2010 at a Berlin clinic for obstetrics in a 27-year-old woman. A girl gave birth to healthy doctors.
In the twin sister, however, enormous brain damage was detected early. With the parents' consent, the doctors injected the twin into the uterus with potassium chloride. The heart has stopped beating. An expert commented the actions of the doctors in court. His approach was for the healthy twin with the lowest risk associated.
"Forget the one with the other"
It was a high-risk pregnancy. The fetuses had shared a mother cake in the uterus. "These children are bonded together for better or for worse," says expert Peter Kozlowski, physician pränatal of Dusseldorf, on the third day of the trial. "The common placenta is the problem."
There were complications. The connections between the twins have led to a disparity in nutrient supply. The healthy fetus was in danger. The doctors had tried to separate the twins' connections with a laser treatment. The condition seemed to normalize, but then they discovered huge brain anomalies in the single twin. After the medical examination, the parents decided for a so-called selective fetozide. That is, the sick twin should be killed to minimize the risk of damaging even the healthy twin.
Any treatment of the sick fetus endangers the healthy fetus
The reviewer Kozlowski speaks from the literature, what interventions are possible, if it is as in this case of complications. It makes it clear that any treatment of the sick fetus endangers the healthy fetus.
From a medical point of view, the risk for the healthy fetus is lower if the killing of the sick fetus occurs as late as possible during pregnancy and "very early to birth". "If the intervention takes place earlier due to the prevention of legal risk, we clearly shift the risk to the mother and the healthy child."
Late abortion or manslaughter?
According to Article 218a of the Criminal Code, the killing of a fetus under certain conditions is permitted until shortly before birth. This intervention must be indicated from the medical point of view in order to protect the pregnant woman from the stress she considers unreasonable.
However, as soon as the uterus is opened or labor begins, the fetus is considered a human being in the eyes of criminal lawyers. His murder is no longer allowed in certain circumstances so-called late abortion, but a crime: manslaughter.
Legally, the case seems rather simple.
It is not medical and ethical.
No reports in the literature
A judge asks if there are reports in the literature on the procedure chosen by the two defendants.
"I didn't find any literature about it", says the expert.
The prosecutor connects. Although it is the least risky procedure, is there no literature on it? "Why not?"
Kozlowski does not want to give an answer. "This doesn't belong here," he says.
"Yes," says the prosecutor.
"Because we are in a legally not clearly defined area," says Kozlowski, "here's why."
"Can it be formulated in such a way that it is not legally permitted?"
"No," says the doctor, "not in my opinion."
"All this leaves me no peace"
It took six years from the first anonymous advertisement to start the main trial before the 32nd criminal division. The healthy girl, who was born with a caesarean section at the time, is now nine years old.
Schertz reads the anonymous announcement, which was repaid only three years after the twin's death.
The announcement reached the police in July 2013 via its Internet portal. "I'm an employee of Maternity Hospital," he says. Fearing for his work, he wanted to remain anonymous. He added the report to the operation in July 2010 when he delivered one of the twins by cesarean section for the first time and then killed the other twin.
He could no longer tolerate such interventions, he wrote the employee. "They are vital children killed here." He continues: "All this leaves me no peace, I can't and I don't want to be a quiet confidant anymore." He asks the prosecutor to check if the clinic violates the laws.
Now everything is going very fast
After the announcement, a little happened in the beginning.
Only in May 2014, the prosecutor resumed the investigation after a new announcement. He hired a medical expert. His report was available in March 2015. Only a good year later, in the summer of 2016, the prosecutor filed charges.
Due to the overload of the criminal court, there were further delays. Finally, the first appraiser left the procedure. The judge's exact circumstances do not call that day. The Düsseldorf expert, Professor Kozlowski, was in charge of a new report. It was the end of 2018. It took another ten months before the trial finally started in October 2019.
A quick judgment is expected
"In any case," said presiding judge Matthias Schertz, repeating: "In the case of a guilty verdict, we must think about how the long trial will affect the sentence." Schertz does not want his words to be interpreted as a prejudice. But his words are a clear indication.
Now everything should go very fast.
Next Tuesday, the fourth day of the trial, prosecutors and defense must plead the case. And on the fifth day of the trial the verdict could fall.