Assisted suicide prompts more recommendations

A room belonging to the assisted suicide organisation, Dignitas Keystone Archive

A national ethics commission is recommending that there should be more external controls in place for people using suicide assistance organisations to end their lives.

The Swiss National Advisory Commission on Biomedical Ethics says organised suicide assistance should only be permitted for people suffering from serious illnesses.

The commission last year recommended that tighter controls should be introduced on assisted suicides, with organisations carrying them out to be put under state surveillance.

In 2003, 272 people committed assisted suicide in Switzerland.

Pressure for such controls has been mounting in recent years, partly because Switzerland has gained a reputation for “death tourism” involving such groups as Exit and Dignitas.

They advise on and facilitate assisted suicide, which has led to increasing numbers of foreigners coming to Switzerland, specifically to die.

In the early 1990s, Exit helped an average of 30 people die a year in the German-speaking part of the country; in 2005 the figure was 162.

In 2000 Dignitas assisted three foreigners end their lives; in 2004 it was 88.

The commission, which presented its latest recommendations at a news conference in Bern on Friday, noted that since there was a legal framework for assisted suicide, it was important to make sure that organisations carrying out the practice were properly controlled.

They should not rely excessively on the principle of the free determination of the patient to the detriment of the protection of life.

The commission said that assisted suicide should not be offered in cases of a temporary crisis, mental illness or in which there was outside pressure.

In its assessment, the commission also defined criteria permitting an evaluation of the desire to die and the awareness of persons wanting to commit suicide to fully understand what they were doing.

It insisted in particular on the need for several face-to-face meetings with a person wanting to commit suicide and recourse to a second opinion.

Ethical reasons

It also said that an assessment based on an exchange of correspondence was not acceptable for ethical reasons.

The commission also warned there were a number of risks that could lead to possible abuse regarding assisted suicide.

It noted that decisions and services offered by organisations should not be motivated by financial gain, and it was unjustified to take advantage of a situation of distress.

It also repeated the importance of external controls of the cases handled by assisted suicide organisations.

The Swiss government said earlier this year that legislation governing assisted suicide in Switzerland was sufficient and it had no plans to tighten the rules.

swissinfo with agencies

In brief

Swiss law tolerates assisted suicide where the act is committed by the patient and the helper has no direct interest.

There are several organisations in Switzerland, such as Exit and Dignitas, which help terminally ill patients choose how to die.

Every fifth suicide in Switzerland, where the suicide rate is significantly higher than the global average, is assisted – in Zurich the figure is one in three.

Euthanasia, illegal in Switzerland, is defined as administering a lethal drug to a person by a doctor or medical staff.

The Swiss Academy of Medical Sciences issued guidelines to doctors in 2004 laying down for the first time conditions under which they could help terminally ill patients die.

In Europe, only the Netherlands and Belgium permit taking the life of a person who wishes to die.