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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?

Reader question: Can foreigners access Switzerland’s assisted suicide clinics?
Australian scientist David Goodall before he died in Basel in May 2018. Photo by SEBASTIEN BOZON / AFP)

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

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TRAVEL NEWS

How do the EU’s new EES passport checks affect the 90-day rule?

As European travellers prepare for the introduction of enhanced passport checks known as the Entry & Exit System (EES), many readers have asked us what this means for the '90-day rule' for non-EU citizens.

How do the EU's new EES passport checks affect the 90-day rule?

From the start date to the situation for dual nationals and non-EU residents living in the EU, it’s fair to say that readers of The Local have a lot of questions about the EU’s new biometric passport check system known as EES.

You can find our full Q&A on how the new system will work HERE, or leave us your questions HERE.

And one of the most commonly-asked questions was what the new system changes with regards to the 90-day rule – the rule that allows citizens of certain non-EU countries (including the UK, USA, Canada, Australia and New Zealand) to spend up to 90 days in every 180 in the EU without needing a visa.

And the short answer is – nothing. The key thing to remember about EES is that it doesn’t actually change any rules on immigration, visas etc.

Therefore the 90-day rule continues as it is – but what EES does change is the enforcement of the rule.

90 days 

The 90-day rule applies to citizens of a select group of non-EU countries;

Albania, Andorra, Antigua and Barbuda, Argentina, Australia, Bahamas, Barbados, Bosnia and Herzegovina, Brazil, Brunei, Canada, Chile, Colombia, Costa Rica, Dominica, El Salvador, Georgia, Grenada, Guatemala, Honduras, Hong Kong, Israel, Japan, Kiribati, Kosovo, Macau, Malaysia, Marshall Islands, Mauritius, Mexico, Micronesia, Moldova, Monaco, Montenegro, New Zealand, Nicaragua, North Macedonia, Palau, Panama, Paraguay, Peru, Saint Kitts and Nevis, Saint Lucia, Saint Vincent and the Grenadines, Samoa, San Marino, Serbia, Seychelles, Singapore, Solomon Islands, South Korea, Taiwan, Timor-Leste, Tonga, Trinidad and Tobago, Tuvalu, Ukraine, United Arab Emirates, United Kingdom, United States, Uruguay, Vatican City and Venezuela.

Citizens of these countries can spend up to 90 days in every 180 within the EU or Schengen zone without needing a visa or residency permit.

People who are citizens of neither the EU/Schengen zone nor the above listed countries need a visa even for short trips into the EU – eg an Indian or Chinese tourist coming for a two-week holiday would require a visa. 

In total, beneficiaries of the 90-day rule can spend up to six months in the EU, but not all in one go. They must limit their visits so that in any 180-day (six month) period they have spent less than 90 days (three months) in the Bloc.

READ ALSO How does the 90-day rule work?

The 90 days are calculated according to a rolling calendar so that at any point in the year you must be able to count backwards to the last 180 days, and show that you have spent less than 90 of them in the EU/Schengen zone.

You can find full details on how to count your days HERE.

If you wish to spend more than 90 days at a time you will have to leave the EU and apply for a visa for a longer stay. Applications must be done from your home country, or via the consulate of your home country if you are living abroad.

Under EES 90-day rule beneficiaries will still be able to travel visa free (although ETIAS will introduce extra changes, more on that below).

EES does not change either the rule or how the days are calculated, but what it does change is the enforcement.

Enforcement

One of the stated aims of the new system is to tighten up enforcement of ‘over-stayers’ – that is people who have either overstayed the time allowed on their visa or over-stayed their visa-free 90 day period.

At present border officials keep track of your time within the Bloc via manually stamping passports with the date of each entry and exit to the Bloc. These stamps can then be examined and the days counted up to ensure that you have not over-stayed.

The system works up to a point – stamps are frequently not checked, sometimes border guards incorrectly stamp a passport or forget to stamp it as you leave the EU, and the stamps themselves are not always easy to read.

What EES does is computerise this, so that each time your passport is scanned as you enter or leave the EU/Schengen zone, the number of days you have spent in the Bloc is automatically tallied – and over-stayers will be flagged.

For people who stick to the limits the system should – if it works correctly – actually be better, as it will replace the sometimes haphazard manual stamping system.

But it will make it virtually impossible to over-stay your 90-day limit without being detected.

The penalties for overstaying remain as they are now – a fine, a warning or a ban on re-entering the EU for a specified period. The penalties are at the discretion of each EU member state and will vary depending on your personal circumstances (eg how long you over-stayed for and whether you were working or claiming benefits during that time).

ETIAS 

It’s worth mentioning ETIAS at this point, even though it is a completely separate system to EES, because it will have a bigger impact on travel for many people.

ETIAS is a different EU rule change, due to be introduced some time after EES has gone live (probably in 2025, but the timetable for ETIAS is still somewhat unclear).

It will have a big impact on beneficiaries of the 90-day rule, effectively ending the days of paperwork-free travel for them.

Under ETIAS, beneficiaries of the 90-rule will need to apply online for a visa waiver before they travel. Technically this is a visa waiver rather than a visa, but it still spells the end of an era when 90-day beneficiaries can travel without doing any kind of immigration paperwork.

If you have travelled to the US in recent years you will find the ETIAS system very similar to the ESTA visa waiver – you apply online in advance, fill in a form and answer some questions and are sent your visa waiver within a couple of days.

ETIAS will cost €7 (with an exemption for under 18s and over 70s) and will last for three years.

Find full details HERE

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