'Your Majesty, if we do not die again, we have no future.' (José Saramago, Death with Interruptions) With these words, the minister addresses the king in José Saramago's novel. In a country where no one has died since the beginning of the year, a lively 'mafia' has started a business of bringing terminally ill people across the border because they are allowed to die there. In recent years, a lively 'death tourism' industry has also emerged in Germany. The number of seriously ill people travelling to Switzerland for euthanasia has risen sharply in recent years. The active and intentional causing of death is a criminal offence in Germany - including in the form of active euthanasia. Doctors also face professional consequences, including the withdrawal of their licence to practise: 'You must not assist in suicide, ' states Section 16 of the MBO-Ä (Medical Professional Code). What legal and ethical challenges does the patient's wish to die pose for the doctor? What restrictions are imposed on them in Germany by criminal law and professional ethics? And what might a patient- and doctor-friendly alternative look like?