They wanted the best for the one twin - now they stand before the district court Berlin for manslaughter of the other twin.
Senior physician Babett R. and the then head physician Professor Klaus V. took a caesarean section in July 2010 in a Berlin clinic for obstetrics in a 27-year-old woman. A girl gave birth to the doctors healthy.
In the twin sister, however, a massive brain damage was detected early. With the consent of the parents, the doctors injected the twin in the womb with potassium chloride. The heart stopped beating. An expert commented in court on the doctors' actions. Her approach was for the healthy twin with the least risks connected.
"Forgood with each other"
It was a high-risk pregnancy. The fetuses had shared a mother cake in the womb. "These children are bound together for better and worse," says expert Peter Kozlowski, Pränatal physician from Dusseldorf, on the third day of the trial. "The common placenta is the problem."
There were complications. The connections between the twins have resulted in unequal nutrient supply. The healthy fetus was in danger. Doctors had tried to separate the connections of the twins by a laser treatment. The condition seemed to normalize, but then they discovered massive brain abnormalities in the one twin. After medical consultation, the parents decided for a so-called selective fetozide. That is, the ill twin should be killed to minimize the risk of harming even the healthy twin.
Any treatment of the diseased fetus endangers the healthy fetus
Reviewer Kozlowski speaks from the literature, which interventions are possible, if it comes as in this case to complications. And he makes it clear that any treatment of the diseased fetus endangers the healthy fetus.
From a medical point of view, the risk to the healthy fetus is lowest if the killing of the diseased fetus occurs as late as possible during pregnancy and "very soon to birth". "If the intervention takes place earlier because of legal risk avoidance, 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 the birth. Such intervention must be medically indicated in order to protect the pregnant woman from stress that she considers unreasonable.
However, as soon as the uterus is opened or the onset labor has begun, the fetus is considered a human in the eyes of criminal lawyers. His killing is then no longer allowed under certain circumstances so-called late abortion - but a crime: manslaughter.
Legally, the case seems pretty simple.
He is not medically and ethically.
No reports in the literature
An associate judge asks if there are reports in the literature about the procedure chosen by the two defendants.
"I have found no literature about it," says the expert.
The prosecutor hooks up. Although it is the least risky procedure, there is no literature on it? "Why not?"
Kozlowski does not want to give an answer. "That does not belong here," he says.
"Yes," says the prosecutor.
"Because we are in a legally not clearly defined zone," says Kozlowski, "that's why."
"Can it be formulated in such a way that it is not legally permissible?"
"No," says the doctor, "not in my view."
"All this leaves me no peace"
It took a good six years from the first anonymous ad to the beginning of the main trial before the 32nd Criminal Division. The healthy girl, who was born by caesarean section at that time, is today nine years old.
Schertz reads out the anonymous ad, which was only refunded three years after the death of the twin.
The ad reached the police in July 2013 via their Internet portal. "I'm an employee of the Maternity Hospital," it says. Fearing for his job, he wanted to remain anonymous. He added the report to the operation in July 2010 when he first delivered one of the twins by caesarean section and then killed the other twin.
He could no longer tolerate such interventions, writes the employee. "They are viable children killed here." He continues: "All this leaves me no peace, I can not and no longer want to be a quiet confidant." He asks the prosecutor to check if the clinic violates laws.
Now everything is going very fast
After the announcement, at first little happened.
Only in May 2014, the prosecutor resumed the investigation after a new ad. She hired a medical expert. Its report was available in March 2015. Only a good year later, in the summer of 2016, the prosecutor brought charges.
Due to overloading the criminal court, there were further delays. Finally, the first appraiser left the procedure. The exact circumstances of the judge does not call that day. The Düsseldorf expert, Professor Kozlowski, was commissioned with a new report. It was the end of 2018. It took another ten months before the process finally began in October 2019.
Fast judgment expected
"Just in case," says presiding judge Matthias Schertz, repeating: "Just in case of a guilty verdict, we need to think about how the lengthy trial will affect sentencing." Schertz does not want his words to be understood as a prejudice. But his words are a clear indication.
Now everything should go very fast.
Next Tuesday, on the fourth day of the trial, prosecutors and defense are to plead. And on the fifth day of the trial the verdict could fall.
