Assisted suicide and euthanasia in Switzerland

Editor—I agree with Hurst and Mauron that the Swiss penal code illustrates how important it is to separate the issue of whether assisting death should be allowed in some circumstances from that of whether doctors should do it.¹ Assistance in dying raises questions that cannot be answered from the perspective of medicine alone.

We should not, however, be misled into denying that doctors inevitably occupy a special position in this issue,² and not just because the barbiturates used in current practice require a medical prescription (there is a movement aiming to make barbiturates for assistance in suicide exempt from prescription). Central to the issue today, in contrast to the age in which the legislation was drawn up, is that assistance in suicide is discussed almost exclusively in the context of a serious and incurable illness.

This means that the treating doctor is the one to negotiate with the patient, relating the wish to die to the medical situation and indicating possible alternatives for treatment or palliative care—assuming that these exist and the patient wants them. As a result, the treating doctor is often the person confronted with the request for assisted suicide. And more and more doctors seem to be willing to meet such requests if they cannot offer any acceptable alternatives, almost always working together with a “right to die” society.

Legal and ethical clarification of the role and responsibility of the doctor in assisted suicide is needed in our country. Ambiguous statements such as “assistance in suicide is not a part of a physician's activity” are not very helpful at this stage.