The Swiss Medical Association has clarified its attitude toward assisted suicide – and it is very restrictive in the face of growing pressures for liberalisation. Assisted suicide has been legal for decades in Switzerland, but since the 1990s, Switzerland has become a haven for foreigners seeking to die.
The guidelines issued last month declare that “assisted suicide for healthy persons is not medically and ethically justifiable”. As such, healthy persons who want to end their lives must prove that their suffering is “unbearable”, and that “other options have been unsuccessful or are rejected by the patient as unreasonable”.
Patients should also have at least two meetings with a doctor– at least two weeks apart –before the final decision to ensure that their desire is “well-considered and enduring”.
The guidelines underscore that the doctor is free to refuse to cooperate:
The true role of physicians in the management of dying and death, however, involves relieving symptoms and supporting the patient. Their responsibilities do not include offering assisted suicide, nor are they obliged to perform it. Assisted suicide is not a medical action to which patients could claim to be entitled, even if it is a legally permissible activity
The guidelines bring the medical association into line with the ethical guidelines issued in 2018 by the Swiss Academy of Medical Sciences. While not legally binding, they will form part of an ethical code for Swiss doctors.
The guidelines were criticised by the major Swiss assisted suicide organisations. In a joint statement, they complained that the guidelines would make it more difficult to provide help to those who want to end their lives. They say that a requirement that a doctor decide on the “severity” of a patient’s condition infringes an individual’s right to define his suffering.
Will the stand of the Swiss Medical Association change how assisted suicide works in Switzerland? Perhaps not.
Dr Philip Nitschke, an Australian activist who is involved in a Swiss assisted suicide clinic, sneered on Twitter: “Swiss Med Assn doesn’t like it when doctors don’t control the process…but luckily, the Med Assn doesn’t make the law…and until they do, healthy people can indeed get help to die in Switzerland.”