Read news from:
Austria
SHARE
COPY LINK
For members

ASSISTED SUICIDE

Do Swiss cantons have different rules on assisted suicide?

Under Switzerland’s federalist structure, cantons have a far-reaching autonomy in deciding what happens on their territories. A few have their own rules on assisted suicide.

Published: 27 September 2023 15:54 CEST
Do Swiss cantons have different rules on assisted suicide?
Assisted dying in elderly care facilities is only allowed in several cantons. Image by Alexa from Pixabay

Switzerland has had an assisted suicide law on the books since 1942 — a constitutional right of each person to determine the manner of his or her death.

This basic principle is the same throughout the country, and while some people and organisations are opposed to this practice, most are in favour of the legislation.

In a survey carried out by Swiss Medical Weekly publication, for instance, 81.7 percent of respondents supported the legality of assisted suicide, as is currently the case in Switzerland, and 60.9 percent stated that they would potentially consider asking for assisted suicide under certain circumstances. 

What does this law say?

The practice is heavily regulated in Switzerland on federal level.

Foremost among the rules is that 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 (this would be euthanasia, which remains illegal in Switzerland).

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 ALSO: What you need to know about assisted suicide in Switzerland

Do these rules differ from one canton to another?

The rules described above are the same throughout Switzerland.

And while cantons have a lot of flexibility to modify existing legislation, cantonal laws cannot contravene federal ones.

In other words, cantons cannot repeal national legislation but, rather, build on it by adding their own rules. 

Relating specifically to assisted dying, “there can be differences in the practical process of assisted suicide — for instance, official investigations following an assisted suicide are not regulated in the same way in every canton,” Muriel Düby, spokesperson for Switzerland’s largest assisted suicide organisation, EXIT, told The Local.

She cited the example of canton of Bern, where “forensics and forensic medicine are always called in, whereas this is not the case in other cantons. This is because federal law, determines the substantive content of criminal procedures, while the implementation is left to the cantons.”

By the same token, there are also different regulations when it comes to assisted suicide in healthcare facilities.

As this is not comprised in the federal legislation, “some cantons have introduced special laws requiring all nursing homes to allow assisted suicide as a basic right,” Düby said.

This is the case in Geneva, Vaud, Neuchâtel, and Valais.

This means that anyone who lives in one of these cantons and is a resident in an elderly care facility, has the right to assisted dying, while this is not the case in the other 22 cantons.

The Geneva ‘exception’
 
While this right has not been challenged in Vaud, Neuchâtel, and Valais, it is currently under threat in Geneva.

At the beginning of September, the Geneva parliament voted to repeal the law passed in 2018 which allows the practice.

In response, EXIT has vowed to force a referendum to stop the canton from revoking the legislation. (Note that this move concerns only healthcare facilities, and is not intended to repeal the entire assisted suicide law).
 
READ ALSO: Can foreigners access Switzerland’s assisted suicide clinics?

Member comments

Log in here to leave a comment.
Become a Member to leave a comment.
For members

ASSISTED SUICIDE

Reader question: Can foreigners access Switzerland’s assisted suicide clinics?

This is not a pleasant subject, but the fact remains that as Swiss ‘death with dignity’ legislation is the most liberal in Europe, a number of foreign nationals choose to die here. What rules must they follow?

Published: 16 August 2023 16:38 CEST
Reader question: Can foreigners access Switzerland’s assisted suicide clinics?

Switzerland has had an assisted suicide law on the books since 1942 — a constitutional right of each person to determine the manner of his or her death.

And because the legislation is the most liberal in Europe (and in most foreign countries as well), a number of terminally sick foreigners have made a sometimes very long trek to Switzerland to put an end to their lives.

One such well publicised case, in 2018, was David Goodall, a 104-year-old Australian scientist who flew to Switzerland from his home in Perth to die in an assisted-suicide facility in Basel, as this option was not available to him in his home country.

A ‘normal’ practice

While many people across the world may be shocked by the medical community legally helping someone to die, in Switzerland it is considered a legitimate way to end one’s life (as the above-mentioned right to self-determination proves).

In fact, the majority of the population supports this right — even if they have no plan to benefit from this practice themselves.

For instance, in 2011, voters in the canton of Zurich rejected proposed bans on assisted suicide and “suicide tourism” (that is, extension of this right to people from abroad). A year later, the national parliament voted against tightening controls on the practice.

Vaud and Valais also subsequently voted to allow this practice in elderly-care facilities for residents in palliative care or those suffering from incurable illnesses or disabilities.

Some elderly care facilities allow assisted suicide on their premises. Photo: Pixabay
 

Do foreigners have access to Switzerland’s end-of-life assistance?

Some organisations don’t provide this service to people coming from outside Switzerland, while others do.

The country’s largest right-to-die group, EXIT, says on its website it only helps people residing in Switzerland (Swiss or permanent foreign residents) or Swiss citizens living abroad — though this act must always take place in Switzerland. 

So if you are foreign national with residence status in Switzerland, you are eligible.

But if you are merely a visitor, you can’t avail yourself of these services through EXIT, though there are other Swiss organisations you can turn to.

Dignitas, located in canton Zurich, was the first to accept people from abroad; to this day, its ‘clients’ are primarily foreigners. 

Another Swiss organisation, LifeCircle, is also open to people from abroad. In fact, this is the group that helped David Goodall die.

How can foreigners (or anyone else) avail themselves of these services?

There are many rules in place.

The first one is that, regardless of whether you live in Switzerland or abroad, you can’t just walk off the street and request assisted suicide.
You must start by joining a right-to-die organisation — this can be done at any time, regardless of your age.

Some people join while they are young and healthy to make sure these services will be available if they should ever need them later on. Also, the law states you can only exercise your right to die if you are mentally alert, so some people prefer to join while they still have the capacity of discernment.

Annual membership at EXIT costs 45 francs; at LifeCircle it is 50 francs; and 80 francs at Dignitas.

There will be additional fees at the time of the actual dying assistance if you choose to opt for that — amounts typically vary from several thousand to over 10,000 francs, mostly for the medical and administrative costs associated with the process.

What else is there to know about assisted suicide in Switzerland?

While for many years, only people suffering from medically-certified terminal conditions qualified for death assistance, rules have been relaxed over the years, to include disabilities and suffering.

Also, Swiss legislation permits assisted suicide only under certain conditions: if the patient is over the age of 18, mentally and physically capable of making the decision to die, and administers the drug him/herself in a private residence.

If a physician or another third party administers the drug, the act would be considered euthanasia, which remains illegal in Switzerland.

Additionally, the person assisting in the suicide must not have any selfish motives.

To ensure that the process complies with the law, 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 that allows a barbiturate to begin flowing into their vein. This footage is used as evidence that they willingly took their own life.

You must release the IV drip yourself, Photo by Hiroshi Tsubono on Unsplash

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

New assisted suicide guidelines went into effect in 2022

In May of last year, the Swiss Academy of Medical Sciences updated its guidelines for assisted suicide. Four points were added to the existing rules :

  • Doctors must now have two consultations with patients (instead of just one), which must be at least two weeks apart, to give the person a chance to change their minds
  • The condition of the patient must be serious and severe to the point where it is “unbearable” (though ‘unbearable’ is clearly subjective and not quantifiable)
  • A patient’s environment must be taken into account
  • There is no ethical or medical justification for providing assisted suicide to healthy people 

These rules are not legally binding. However, they have since been adopted by the Swiss Medical Association (FMH). 

Around 90 percent of Swiss doctors and medical professionals – including those who provide assisted suicide services – are members of the FMH. 

READ ALSO: What to know about Switzerland’s latest court judgement on assisted suicide

SHOW COMMENTS