Euthanasia in Switzerland
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Switzerland has legislatively permitted assisted suicide since 1942. For example, lethal drugs may be prescribed as long as the recipient takes an active role in the drug administration. Euthanasia (such as administering a lethal injection) is not legal. The law does require a physician to be involved. It also does require the recipient to be a Swiss national. This latter aspect of the law is unique in the world, and the nation has come to be known for the phenomenon of "suicide tourism.".
The legality of assisted suicide is a result of article 115 of the Swiss Criminal Code, in effect since 1942, which provides:
- "Inciting and assisting suicide: Any person who for selfish motives incites or assists another to commit or attempt to commit suicide shall, if that other person thereafter commits or attempts to commit suicide, be liable to a custodial sentence not exceeding five years or to a monetary penalty."
Consequently, assisting suicide is a crime only if the motive for doing so is selfish, such as personal gain.
When an assisted suicide is declared, a police inquiry may be started. Since no crime has been committed in the absence of a selfish motive, these are mostly open and shut cases. Prosecution can occur if doubts are raised about the patient's competence to make an autonomous choice, or about the motivation of anyone involved in assisting the suicide.
Article 115 was interpreted as legal permission to set up organizations administering life-ending medicine only in the 1980s, 40 years after its coming into effect.
Role of physicians in assisted suicide
Article 115 does not give physicians a special status in assisting suicide, although they are most likely to have access to suitable drugs. Ethical guidelines have cautioned physicians against prescribing lethal drugs. However, the guidelines also recognize that, in exceptional and clearly defined cases, physicians may justifiably assist suicide. Based on more recent ethical, juridical and medical statements, a prescription of Sodium-Pentobarbital is not necessarily contra-indicated, and thus is no longer generally a violation of medical duty of care.
Assisted suicide and mental illness
Evaluating a wish for assisted suicide requires distinguishing between a wish to die that reflects a curable psychic distortion, which calls for treatment, and a wish that is based on a self-determined, carefully considered and lasting decision made by a lucid person, which possibly needs to be respected. In the latter case, under certain circumstances even a mentally ill person may be granted help to commit suicide. Whether the prerequisites for this are satisfied cannot be evaluated separately from medical – especially psychiatric – special knowledge and proves to be difficult in practice. Therefore, the appropriate assessment requires the presentation of a special in-depth psychiatric opinion. In an essay in the Hastings Center Report, bioethicist Jacob M. Appel advocated adopting similar rules in the United States.
All forms of active euthanasia like administering lethal injection remain prohibited in Switzerland. Swiss law only allows providing means to commit suicide, and reasons for doing so must be altruistic.
Recent debate in Switzerland has focused on assisted suicide rights for the mentally ill. A decision by the Swiss Federal Supreme Court on November 3, 2006, laid out standards under which psychiatric patients might terminate their lives: “It cannot be denied that an incurable, long-lasting, severe mental impairment similar to a somatic one can create a suffering out of which a patient would find his/her life in the long run not worth living anymore."
Euthanasia organisations have been widely used by foreigners, most notably Germans, as well as the Swiss, in what critics have termed suicide tourism. Around half of the people helped to die by the organisation Dignitas have been Germans.
In July 2009, British conductor Sir Edward Downes and his wife Joan died together at a suicide clinic outside Zürich "under circumstances of their own choosing." Sir Edward was not terminally ill, but his wife was diagnosed with rapidly developing cancer.
In a referendum on 15 May 2011, voters in the Canton of Zurich have overwhelmingly rejected calls to ban assisted suicide or to outlaw the practice for non-residents. Out of more than 278,000 ballots cast, the initiative to ban assisted suicide was rejected by 85 per cent of voters and the initiative to outlaw it for foreigners was turned down by 78 per cent.
- Hurst SA, Mauron A (February 2003). "Assisted suicide and euthanasia in Switzerland: allowing a role for non-physicians". BMJ 326 (7383): 271–3. doi:10.1136/bmj.326.7383.271. PMC 1125125. PMID 12560284.
- Appel JM (2007). "A suicide right for the mentally ill? A Swiss case opens a new debate". Hastings Cent Rep 37 (3): 21–3. doi:10.1353/hcr.2007.0035. PMID 17649899.
- http://www.assistedsuicide.org/suicide_laws.html Assisted Suicide Laws Around the World, compiled by Derek Humphry
- Lundin, Leigh (2009-08-02). "YOUthanasia". Criminal Brief. Retrieved 2009-08-27.
- A Swiss assisted suicide organization that facilitates assisted suicides for the hopelessly physically and mentally ill.
- "Swiss voters back assisted suicide" BBC News: 15.05.2011: http://www.bbc.co.uk/news/world-europe-13405376
- Brochure "How DIGNITAS works"
- EXIT-Deutsche Schweiz
- EXIT A.D.M.D. Suisse romande (French)
Links in languages without a Wikipedia article about Euthanasia in Switzerland:
- "Nordmenn drar til Sveits for å dø" [Norwegians go to Switzerland to die]. Verdens Gang (in Norwegian). 2013-09-14.