Assisted Suicide in Switzerland

Abstract

Background: The aim of this research project, part of a program initiated by the Swiss Federal Council, was to trace the development of organized assisted suicide in Switzerland, starting from the very first case in 1985. Methods: Retrospective data on 3666 death records from Swiss institutes of forensic medicine for the years 1985 to 2014 were systematically compiled, read into a database, and for the most part quantitatively evaluated. Results: Alongside a marked increase in the overall number of assisted suicides since the turn of the century, the number of people traveling to Switzerland from other countries-predominantly Germany-for this purpose has risen steadily. The proportion of women was 60%, and the age at death ranged from 18 to 105 years (median 73). The largest diagnostic category was malignancy overall, neurological disease for those from other countries. The next largest category was age-related functional limitation, e.g., sensory impairment (loss of sight and hearing), the consequences of which were stated in writing as the reason for the wish to die. Following the Swiss Federal Court's promulgation of binding requirements in 2006, the documentation contained in the death records for the subsequent period up to 2014 is much more detailed, but still not uniform or even necessarily complete. Conclusion: The number of candidates for organized assisted suicide increased steadily during the study period, but no standard procedures were followed. The question therefore arises of whether further regulation or the introduction of a central registration office to maximize standardization and promote transparency would lead to improved quality assurance.

Assisted dying around the world: a status quaestionis

“…Since the 1980s, right-to-die organizations have been interpreting the law as legal permission to operate organizations to support people who wish to obtain assisted suicide, including nonresidents (7). In 2006, the Federal Court of Switzerland extended the law to include those with mental disorders and imposed standardized process rules requiring increased documentation and reporting from the organizations that provide assisted suicide (19). After efforts to legalize euthanasia in the United States in the early 1900s failed, it wasn't until the 1980s and the promotion of pathologist, Dr. Jacob "Jack" Kevorkian that the national conversation was renewed (8).…”

“…In Canada, euthanasia deaths accounted for about 1.12% of all deaths between January-October, 2018 (12). In Switzerland, there has been a consistent increase in cases of assisted suicide among Swiss residents and residents from other countries (primarily Germany) since 2000 (19). Approximately 150-200 people from other countries travel to Switzerland every year to access physician-assisted suicide, a practice known as "suicide tourism" (31).…”

“…Approximately 150-200 people from other countries travel to Switzerland every year to access physician-assisted suicide, a practice known as "suicide tourism" (31). The annual number of cases of assisted suicide in Swiss residents nearly doubled from 500 cases in 2012, to nearly 1,000 cases in 2016, equalling about 1.5% of all deaths (19). The mortality follow-back survey conducted in 2013 found that 1.0% of all deaths were attributed to assisted suicide in the German-speaking part of Switzerland (21).…”

Prevalence of somatic and psychiatric morbidity across occupations in Switzerland and its correlation with suicide mortality: results from the Swiss National Cohort (1990–2014)

“…Suicides were coded as principal cause in all cases except those who died from assisted suicide. In this study, we only considered the former, given that the latter, strictly reserved to specific conditions, are not relevant for investigating the work-related risk factors [23]. For each identified suicide case, two physicians independently examined the reported consecutive and concomitant diseases and assigned them to one of 16 categories of morbidity, according to their ICD code (Table 1).…”

Angekündigter assistierter Suizid in der Schweiz – Ein Fallbericht

“…Im vorliegenden Fall berichten die AutorInnen über eine Patientin, welche einen assistierten Suizid in der Schweiz geplant hatte, und diskutieren weiterführend die ethischen und juristischen Hintergründe zu diesem Thema. In der Schweiz wird Beihilfe zum Suizid seit 1985 angeboten, wobei aktuell über fünf Organisationen hier tätig sind -mit heterogenen Kriterien, unter welchen Bedingungen im Hinblick auf Alter und Grunderkrankung Menschen ihr Angebot in Anspruch nehmen dürfen; die Kosten dafür schwanken und liegen zwischen freiwilliger Spende bis hin zu mehreren tausend Euro/Schweizer Franken [5].…”