Can a change be expected? Will the Swiss Law Change

“The law is straightforward.   But there is the Statutory Rule for medical doctors as well …..”

There are three things that are unique about the Swiss law on assisted suicide.  

The first is that it enables the country to accept visitors from elsewhere, specifically for the purpose of ending their own lives there*.  

The second is that there is not a specific single Act regulating the matter. Instead , assisted suicide takes place under a framework of articles in several different Acts, court judgements and “soft law”. In England and Wales, suicide itself was specifically legalised by the 1961 Suicide Act and the same legislation also specifically confirmed that assisting a suicide was to remain a crime. Switzerland, however, developed as a federal nation – on the basis of liberal principles, including the belief that sometimes people really wanted to end their suffering and in those circumstances should be able to receive knowledgeable support to do so.

The framework is such that someone must be over 18 and must be of sound mind. Crucially, they must conduct the act themselves. If a third person (such as a doctor) carried out the last act then it would not be “assisted suicide” but “voluntary euthanasia”, which is a criminal offence **.

Every assisted suicide must be reported to the police and that is followed by a State Attorney’s investigation. Only when the State Attorney is satisfied that no offence has been committed can the investigation be closed.

Third there is also a “Statutory Rule” for medical doctors. If this is not followed then the doctor can find his or her career at risk. If felt appropriate, the State Attorney can refer any case to the respective Cantonal Health Authority. That Authority can then, if it feels the Statutory Rule has been broken, open an administrative procedure against the doctor who prescribed the Pentobarbital. It is the Authority that issues the doctor’s work permit and it can withdraw that if it needs to do so. What this means in practice is that, whilst (unlike all other countries) doctors do not need to be involved in the VAD decision itself, they must nonetheless be involved at the prescription stage.

Attempts to change

In 2009 a conservative federal government member brought to public debate a proposal for “regulating” assisted suicide which, on close inspection, revealed itself to be an attempt to reduce access to choice. At the same time several parliamentary members’ were targeting the same thing. Also, in the Canton of Zurich, two smaller parties, both from religious backgrounds, aimed to restrict the availability of assisted suicide; one proposed that assisted suicide should only be available to people living within the Canton and the other said the Federal Government should ban assisted suicide entirely.

All such attempts were defeated. However, the sentiments that lay behind those attempts have not gone away. More recent efforts have been based upon new “ethical guidelines” or “research project” results. For example, one theologian-led “research” organisation recently published an article so misleading that the Journal of Medical Ethics had to accept an informed rebuttal.

In 2018, the Swiss Academy of Medical Science and the Swiss medical Association were found to have been working together, without informing the public, to introduce some new rules and bits of bureaucracy that would have had a clear impact upon medical doctors involved with any form of assisted suicide.

In the late summer of 2022 there was an attempt, unsuccessful, to ensure that at least two weeks must pass between the first and the second of the doctor’s consultations – and that both had to be in person.

What is driving this opposition from within Switzerland ?   Certainly, the conservatives (small “c”) and some religious groups are playing their part.   Maybe also, although the current practice continues to enjoy majority public support, some Swiss citizens are just not that worried about defending one of the freedoms their nation has had for more than forty years.

* Although it is possible this could also be done in Colombia
** It is worth noting that in the UK case of Ninian v. Findlay and Others, the court did not regard the need for self-administration as being particularly significant