||Half Swiss deaths dubbed
Scotland on Sunday
June 29, 2003
ASSISTED suicide plays a role in more than half of all deaths in
Switzerland, according to a major new study that confirms the countrys
reputation as the euthanasia capital of Europe.
A survey by the University of Zurich of 5,000 deaths in the country
found that 51% were a result of end-of-life decisions.
This would mean about 31,000 out of the 62,000 Swiss citizens who
die annually were helped to do so by doctors.
The study, which looked at a total of 30,000 deaths in six European
countries, involved interviewing doctors who signed the death certificates
on condition of guaranteeing their anonymity.
It is thought a growing number of foreigners travelling to Switzerland
for help to commit suicide is boosting the figures.
The study, which was carried out in 2001 and 2002 and is the first
of its kind in Europe, found Swiss doctors were co-operating with
patients requests to be allowed to die in several ways.
Under Swiss law, doctors are allowed to provide people with the
means to end their life as long as the person is deemed to be making
a rational decision to die and does it themselves.
Those who want to die in this way need to produce records about
their illness and a letter explaining why they want to die. They
also must have an appointment with a Swiss doctor.
In other cases, the survey found doctors administered drugs to
alleviate pain, knowing the medication would hasten death, or withheld
some treatments to fulfil the wish of a terminally-ill patient to
die more quickly.
Active euthanasia, where, for example, a doctor personally administers
a lethal cocktail of drugs, is illegal in Switzerland, but a small
number of doctors admitted to the practice.
The Zurich University team of Dr Karin Faisst, Dr Georg Bosshard
and sociologist Susanne Fischer said the survey confirmed for the
first time what had been suspected about the high numbers of assisted
suicides in Switzerland.
Bosshard said: "Assisted suicide in Switzerland has not been
punishable by law for a long time, and although regulations are
in place governing the procedures, we place more emphasis on the
wishes of the patient, unlike in Britain.
"The results were not particularly shocking and most people
involved in the study expected them to be around that level. In
Switzerland the subject is widely discussed, but there are many
other countries in Europe, including Britain, where I believe more
inroads need to be made.
"Doctor support for euthanasia is split, although there are
more physicians who are in favour of some form of assisted suicide.
General public opinion is certainly for the practice, with at least
three-quarters of the country in favour."
"Assisted suicides will probably increase in other countries
in the future too, although I believe the results of the Swiss study
will probably remain at this level for some time, without drastically
Bosshard, who is a member of the Swiss Academy for Medical Sciences,
said the practice of euthanasia always had to come down to individual
He said: "I dont think you can necessarily label the
practice good or bad. Each individual case has to be looked at carefully."
The other countries studied were Belgium, Denmark, Italy, the Netherlands
Active euthanasia, which is illegal in most EU countries except
the Netherlands, is still rare or hidden. Almost 3% of deaths in
Holland involved doctors administering lethal drugs to patients
who wanted to die compared with 0.27% in Switzerland.
Bosshard said: "The Netherlands has the highest number of
active euthanasia cases, and I thought Switzerland would have a
similar number, but this was not the case. On the other hand there
are more cases of passive euthanasia in Switzerland."
Faisst, of Zurich Universitys Institute for Social and Preventative
Medicine, said even in Switzerland the medical profession did not
like to talk about helping people to die.
"The doctors often feel they are on their own, and some are
unhappy about even discussing it," she said. "It may be
that this research will help promote more dialogue involving doctors
and the public."
The small Alpine countrys reputation as a leading advocate
of assisted suicide grew with the setting up of a number of private
organisations that offered to help people to die.
Dubbed suicide tourism the number of people visiting
the organisations from Switzerland and abroad has drastically increased
over the past few years.
There is now concern that the trend is causing an image problem
for the country.
Zurichs chief public prosecutor Andreas Brunner said: "Switzerland
is one of the only countries in Europe to have such liberal laws
on euthanasia. "There is probably a good reason why other nations
do not have such a law and as such those countries citizens
should not be allowed to travel abroad for something that is illegal
in their own country.
"Before long the only reputation Switzerland will have is
as a country to come to die in."
He added that he was not against the practice of euthanasia in
general but that it should not be open to people coming from abroad.
"I would like to see a law that allows only Swiss citizens
to appeal for assisted suicide," said Brunner.
A Swiss group called Dignitas, which pledges to help anyone who
wants to "die with dignity", has created headlines throughout
Ludwig Minelli, its general secretary, said he found the proposal
to limit euthanasia to Swiss citizens offensive and blatantly prejudiced.
He said: "The whole thing is ridiculous."
The proposal mirrored the countrys isolationist foreign policy
during the Second World War, he claimed.
"Switzerland closed its borders and sent those who had come
to this country for refuge back to their own countries, where many
were persecuted and sent to concentration camps," Minelli said.
"The public prosecutors office now wants to send terminally
ill foreigners back to their own countries where all they face is
misery and painful deaths."
Minelli, who by profession is a lawyer, added: "Our founding
principal is that everybody has the right to put an end to their
life if their suffering is unbearable and there is no hope of relief."
He added he hoped the example they were setting in Switzerland
might lead to a more liberal view on euthanasia in other countries.
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