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Zurich hosts global dignity in death debate

Groups supporting the right to hasten dying will meet in Zurich this week for a global conference on assisted suicide, reigniting the debate on dignified death.

Representatives from about 45 countries are expected at the five-day congress of the World Federation of Right to Die Societies, held every two years.

The venue of the 2012 meeting honours the 30th anniversary of Zurich-based Exit, a group carrying out assisted suicides in Switzerland where the practice is legal under certain conditions.

“It’s no longer necessary to make the argument in Switzerland,” said Exit vice president Bernhard Sutter.

“Lots of people are nevertheless interested in the subject and are asking, for example, what will happen the day they suffer from Alzheimer’s,” he said.

The conference will hear from acclaimed British fantasy author Sir Terry Pratchett, himself diagnosed with Alzheimer’s several years ago and patron of pro-choice group Dignity in Dying.

Pratchett will address the conference during its open day on Friday along with Ludwig Minelli, founder of Swiss assisted suicide group Dignitas, and German writer Ueli Oswald whose father died with Exit.

The meeting is otherwise reserved for members of the Federation.

“The situation concerning assisted suicide varies widely from country to country,” said Sutter.

“The aim of the conference is essentially an exchange between the participants on political work, lobbying and initiatives” to make the argument for assisted suicide, he said.

The congress, last held in Melbourne in 2010, will also see the detractors of assisted dying have their say.

Human Life International (HLI) Switzerland, which campaigns on abortion, contraception, sex education and euthanasia, plans to hold a demonstration on the fringes of the forum on Friday.

“Our aim is not to disrupt the conference,” said secretary Christoph Keel.

“Our aim is to put other arguments to the visitors of the congress. We are going to organise discussions and we will be there at the entrance (of the conference) to distribute leaflets,” he said.

Sutter from Exit says he is “completely accepting” of different views.

“It’s just a shame that the opposite camp is not tolerant too,” he said.

Three hundred Swiss residents died in assisted suicides in 2009, nine out of 10 of them aged over 55, according to official statistics published for the first time in March this year.

The Swiss Federal Statistics Office data does not take into account foreigners who come to Switzerland for assisted suicide.

Between 1998 and 2011, Dignitas helped 1,169 non-nationals die, mostly Germans (664), followed by patients from Britain (182) and France (117).

Exit meanwhile stipulates that clients must be resident in Switzerland.

Swiss law says a person may be given “passive” or “indirect active” assistance to suicide, such as being supplied with a lethal dose of a drug, provided it is not done for selfish motives or for gain.

The government last year rejected proposals to tighten the rules.

Politicians had considered imposing certain “duties of care” to employees of organisations offering assisted suicide and an outright ban on the groups altogether.

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EUTHANASIA

Switzerland: What is the difference between assisted suicide and euthanasia?

While the terms often are used interchangeably, assisted suicide and euthanasia - and the laws that govern them - are quite different. Here’s what you need to know.

A person in a medical coat holds hands with another
Euthanasia and assisted suicide might be spoken of in the same breath, but they are quite different. Here's what you need to know. Photo by Matheus Ferrero on Unsplash

The terms assisted suicide, assisted dying and euthanasia are often used interchangeably – even by media and politicians covering the matter. 

There are however some key differences, both in terms of the legal situation and the practice itself. 

Assisted suicide is where a medical professional, usually a doctor but sometimes a pharmacist or other specialist, provides some form of medication to assist a patient as they commit suicide. 

EXPLAINED: How foreigners can access assisted suicide in Switzerland

Crucially, it is the patient who takes the final step, i.e. by taking a medication or by pressing a switch through which the medication is administered. 

Euthanasia on the other hand is where the medication which ends someone’s life is administered by a doctor or medical professional. 

Euthanasia is sometimes known as voluntary euthanasia, which references the fact that the patient volunteers for the process by providing consent. 

Other forms of medical intervention which lead to death – for instance turning off life support for someone who has been in a long-term coma – do not fit within the definition of voluntary euthanasia. 

The term ‘assisted dying’ is used as a grouping term to refer to both assisted suicide and euthanasia, although media sources – particularly in the United Kingdom – often use assisted dying when referring primarily to assisted suicide. 

What are the rules for assisted suicide and euthanasia in Switzerland? 

The law in Switzerland recognises the distinction between assisted suicide and euthanasia. 

Euthanasia is not permitted under law in Switzerland, while assisted suicide is allowed for both locals and foreigners. 

While article 115 of the Swiss penal code prohibits assisted suicide for “self-serving reasons” and article 114 prohibits “causing the death” of a person for “commendable motives, and in particular out of compassion for the victim”, assisted suicide for non-selfish reasons is not specifically prohibited as long as certain conditions are met. 

The Swiss supreme court has ruled the following: people must commit suicide by their own hand, for example, by taking medication themselves. A doctor cannot administer a lethal injection without being liable for criminal prosecution.

People must also be aware of actions they are undertaking and have given due consideration to their situation. In addition, they be consistently sure they wish to die, and, of course, not be under the influence of another person, or group of persons.

READ MORE: What you need to know about assisted suicide in Switzerland

Several other jurisdictions across Europe and the globe also make a legal distinction between the two, although euthanasia is legal in some countries including the Netherlands, Belgium, Luxembourg and Columbia. 

What is the medical procedure involved?

Most Swiss associations request that patients drink sodium pentobarbital, a sedative that in strong enough doses causes the heart muscle to stop beating.

Since the substance is alkaline, it burns a bit when swallowed.

A professional prepares the needle, but it is up to the patient to open the valve that allows the short-acting barbiturate to mix with a saline solution and begin flowing into their vein.

A video is shot of the patient stating their name, date of birth and that they understand what they are about to do. The camera keeps rolling as they open the valve and the footage is used as evidence that they willingly took their own life.

It usually takes about 20 to 30 seconds for the patient to fall asleep.

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