SHARE
COPY LINK
For members

ASSISTED DYING

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

Member comments

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

ASSISTED DYING

First ‘death pod’ to be used in Switzerland soon

An assisted dying group expects a portable suicide pod to be used for the first time in Switzerland, potentially within months, providing death without medical supervision, it said Wednesday.

First 'death pod' to be used in Switzerland soon

The space-age looking Sarco capsule, first unveiled in 2019, replaces the oxygen inside it with nitrogen, causing death by hypoxia. It would cost $20 to use.

The Last Resort organisation said it saw no legal obstacle to its use in Switzerland, where the law generally allows assisted suicide if the person commits the lethal act themselves.

“Since we have people indeed queueing up, asking to use the Sarco, it’s very likely that it will take place pretty soon,” The Last Resort’s chief executive Florian Willet told a press conference.

“I cannot imagine a more beautiful way (to die), of breathing air without oxygen until falling into an eternal sleep,” he added.

‘Press this button’ to die

The person wishing to die must first pass a psychiatric assessment of their mental capacity — a key legal requirement.

The person climbs into the purple capsule, closes the lid, and is asked automated questions such as who they are, where they are and if they know what happens when they press the button.

“‘If you want to die’, the voice says in the processor, ‘Press this button’,” said Sarco inventor Philip Nitschke, a leading global figure in right-to-die activism.

He explained that once the button is pressed, the amount of oxygen in the air plummets from 21 percent to 0.05 percent in less than 30 seconds.

“Within two breaths of air of that low level of oxygen, they will start to feel disorientated, uncoordinated and slightly euphoric before losing consciousness,” Nitschke said.

“They will then stay in that state of unconsciousness for… around about five minutes before death will take place,” he added.

The Sarco monitors the oxygen level in the capsule, the person’s heart rate and the oxygen saturation of the blood.

“We will be able to see quite quickly when that person has died,” said Nitschke.

As for someone changing their mind at the very last minute, Nitschke said: “Once you press that button, there’s no way of going back.”

First user 

No decision has been made over the date and location of the first death, or who the first user might be.

Such details would not be made public until after the event.

“We really don’t want a person’s desire for a peaceful passing in Switzerland to turn into a media circus,” said lawyer Fiona Stewart, who is on The Last Resort’s advisory board.

She said it would be used “in a very secluded location, in the beauty of nature”, though it had to be on private property.

Asked if the first use would be this year, she replied: “I would say yes.”

The minimum age limit is set at 50, though if someone over 18 was seriously ill, “we would not want to deny a suffering person based on their age”, said Stewart.

The capsule can be reused.

Nitschke’s Exit International organisation, which owns the Sarco, is a non-profit group funded by donations.

Stewart said the only cost for the user would be 18 Swiss francs ($20) for the nitrogen.

Development and debate 

The capsule’s potential use has raised a host of legal and ethical questions in Switzerland, reigniting debate on assisted dying.

The Valais and Schaffhausen cantonal doctors have banned its use, while other cantons have voiced reservations.

“It’s our understanding that there’s no legal impediment to the Sarco being used… despite what any canton says,” Stewart insisted.
Nitrogen, which forms 78 percent of the air, is “not a medical product… it’s not a dangerous weapon”, she added.

“We’re looking to de-medicalise assisted suicide, because a Sarco doesn’t require a doctor to be in close proximity,” said Stewart.

Only once a person has died would the Swiss authorities be called.

The 3D-printable capsule cost more than 650,000 euros (728,000 francs) to research and develop in the Netherlands over 12 years.

Stewart said it had been tested with instruments in a workshop in Rotterdam over the last 12 months. It has not been tested on humans or animals.

The current Sarco could only accommodate someone five feet and eight inches (1.73 metres) tall. The development team is seeking to build a double Sarco so couples could end their lives together.

Future Sarcos could cost around 15,000 euros (14,500 francs). The Sarco will never be permitted for use in capital punishment, said The Last Resort.

SHOW COMMENTS