In the United States, “aid-in-dying” as some advocates call it, is legal in New Mexico, Oregon, Vermont, Washington, and Montana. But the conditions under which a physician can help someone die are regulated—for example, in Washington, the person must be a resident, and be terminally ill with less than six months to live.
But Switzerland does not have clear regulations on assisted suicide, as highlighted by a new study published in the Journal of Medical Ethics, though it’s not for lack of trying. Several proposed regulations over the past few decades have failed. Six voluntary right-to-die organizations exist in the country, each with their own criteria, and four of them offer services to residents of other countries.
The Swiss researchers write that “the six right-to-die organizations assist in approximately 600 cases of suicide per year; some 150 to 200 of which are suicide tourists,” or people coming to Switzerland seeking aid-in-dying. The study looks at the data on suicide tourism in the greater Zurich area between 2008 and 2012.
In almost all of the instances of people coming to Switzerland from a foreign country seeking assisted suicide, Dignitas was the organization involved, and the people typically died by ingesting sodium pentobarbital (in all but four cases in 2008, in which they died by inhaling helium).
Almost half of the “suicide tourists” came from Germany—the U.K. and France had the next highest percentages. People seeking assisted dying were between 23 and 97 years old, with a median age of 69, and nearly 60 percent were women. The most common reasons cited for pursuing assisted suicide were neurological disease (47 percent) and cancer (37 percent).
“After a decrease between 2008 and 2009, the number of suicide tourists doubled between 2009 and 2012,” the study says. “The initial fall could be explained by negative media reporting on the four cases of [assisted suicide] with helium inhalation in spring 2008. The deaths were described as excruciating.”
Not only did the number of suicide tourists increase in that time, but they came from more and more other countries. The study posits that other European countries might change their legislation as a result of this growing phenomenon. (“In the U.K., at least, ‘going to Switzerland’ has become a euphemism for [assisted suicide],” the researchers write.) And indeed, they do note that all three of the countries where suicide tourism was most prevalent (Germany, France, and the U.K.) introduced new assisted suicide legislation during the period studied. The proposed German law would forbid advertising for aid-to-dying abroad; the proposed French and U.K. bills would allow physician-assisted suicide for terminally ill patients.
“Political debate in Switzerland and other countries is continuing, with the possibility of further amendments in the near future, in both Switzerland and elsewhere, unless Switzerland issues clear and structured regulations on suicide tourism,” the study says.