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ASSISTED SUICIDE

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

Switzerland's highest court this week ruled that patients with mental illnesses can be eligible for assisted suicide even without a psychiatric report.

Foreigners can access assisted suicide in Switzerland.
Foreigners can access assisted suicide in Switzerland. Photo by Marcelo Leal on Unsplash

What’s happening?

The landmark decision was handed down on Wednesday by the Swiss Federal Supreme Court, reported Swiss broadcaster SRF.

The ruling involved a Swiss doctor called Erika Preisig, a doctor and assisted dying advocate based in the canton of Basel-Country, who was prosecuted in 2021 for assisting a mentally ill patient to die.

The prosecutor was of the opinion that Preisig had committed homicide because she had not obtained a psychiatric evaluation on the person before assisting the suicide.

Preisig was acquitted of charges of intentional homicide by the Federal Court, which dismissed the appeal by the public prosecutor’s office of Basel-Country canton.

Preisig had previously been acquitted by the cantonal court, but the public prosecutor appealed the ruling and took the case to the Federal Supreme Court to urge for clarification.

What do previous rulings say?

In 2006, the Federal Supreme Court ruled that, in principle, it was permissible to assist a mentally ill person in committing suicide. But only if the wish to die is based on a well-considered decision by a person capable of making a judgement.

According to the highest judges in 2006, the wish to die must also not be an expression of a treatable mental disorder, and this must be clarified by a psychiatric report. Such a report was not available in the Preisig case.

What does it mean?

The Federal Supreme Court has clarified the situation: although Preisig had not obtained a psychiatric report, she had studied the medical records, had intensive discussions with the woman, questioned relatives and obtained a second opinion. The mentally ill woman was understood to have made a well-considered decision and was capable of judgement. 

According to court documents, the woman had been suffering for several years and had undergone countless physical and psychiatric examinations.

The Federal Supreme Court confirmed that Preisig could assume, even without a psychiatric expert opinion, that the woman had a permanent wish to die, as she suffered from an incurable, permanent, severe mental impairment.

Federal judges believed all of this this was enough to justify the decision to help the patient to die. 

With its judgment, federal judges have upheld Switzerland’s liberal law on assisted dying, as well as confirmed that a report from a psychiatrist is not always required to assist mentally ill people to die.

What is assisted suicide in Switzerland?

Switzerland’s assisted suicide laws allow people to take their own lives with the assistance of medical professionals.

It is a relatively unique scheme, with few other countries allowing the practice.

One important note to keep in mind is the difference between euthanasia and assisted suicide. Assisted suicide still requires the person in question to administer the suicide themselves, while euthanasia is where a doctor takes this final step.

Euthanasia is not allowed in Switzerland, while assisted suicide is allowed for both Swiss people and foreigners. Assisted suicide is legal in Switzerland on compassionate grounds.

Last year, the Swiss Academy of Medical Sciences laid out new guidelines for assisted suicide practices to be tightened in Switzerland.

READ ALSO: What are Switzerland’s new assisted suicide rules?

These guidelines include a more stringent test for whether you should be allowed assisted suicide services, along with a longer waiting period and more meetings with doctors.

The main associations administering assisted suicides are Exit, Dignitas, Ex International, and lifecircle.

READ ALSO: How foreigners can access assisted suicide in Switzerland

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ASSISTED SUICIDE

‘Tesla of assisted suicide’ to be used for first time in Switzerland

A new ‘death capsule’ known as the ‘Sarco pod’ will be used for the first time in Switzerland in the coming months. 

'Tesla of assisted suicide' to be used for first time in Switzerland

The device, described asthe Tesla of assisted suicidewill enter service  in the next few weeks, according to a report by the Neue-Zurcher-Zeitung. 

The device works by flooding a 3D-printed capsule with nitrogen gas at the press of a button from the occupier, leading to painless asphyxiation without ingesting a poisonous substance. 

Christian Jackowski, director of the Institute of Forensic Medicine at the University of Bern, told the NZZ thatthe lack of oxygen is perceived as pleasant in the body.”

Before the device is used, the occupant must complete a short computerised test, which enables the capsule to be used for 24 hours before the test must be taken again

The device has been developed by the assisted suicide organisation Exit International, led by the former Australian doctor, Philip Nitschke.

Legal by omission

Assisted suicide is legal under Swiss law, due to a lack of specific legislation.

While suicide forself-serving reasonsorout of compassion for the victimis specifically prohibited, assisted suicide for non-selfish reasons is not, and that creates a loophole.

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

It is now, however, a relatively complicated process for those who wish to take their own lives. 

There are several criteria which must be met to avoid police suspicion of a crime, such as evidence that the person choosing to take their own life is of mind, and not under the influence of others. 

Furthermore, they must have given due consideration to the choice, and have recorded statements expressing their willingness to die.

Those who wish to make use of Switzerland’s legal situation regarding assisted suicide also make use of services such as Nitschke’s Exit International, Dignitas or lifecircle, and the process usually takes place at a clinic. 

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

These manage the process, as well as supplying the sodium pentobarbital which the patient must self-administer. This drug causes the heart to stop beating, bringing on death. 

1,252 people chose to take their lives via the process in 2023, according to Exit

A controversial figure

Philip Nitschke has long campaigned for the right to die via such devices as the Sarco pod. 

In the 1990s, he was a lead figure in the campaign to briefly legalise assisted dying in Australia’s Northern Territory. 

He continued to campaign on the issue, despite having his medical license suspended in 2014. 

In 2015 he relocated to the Netherlands, where assisted dying is legal. 

He began working on the Sarco pod, along with industrial designer Alexander Bannick in 2017. 

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