Swiss canton sanctions assisted suicide

The canton of Vaud has voted in favour of allowing assisted suicide to take place in nursing homes, making it the first formal Swiss law on the subject.

More than 61 percent of voters in Vaud opted on Sunday in favour of allowing assisted suicide to take place in nursing homes, newspaper Tages Anzeiger reported.

The initiative came about as a local governmental counter-proposal to an earlier initiative launched by Exit, the Swiss organization that assists in suicides.

Exit had wanted to make assisted suicide available in all hospitals as well as to empower patients in all cases to be able to make the final decision on how they wished to die.

That proposal was rejected in favour of the counter-initiative which opens the door for patients who meet certain criteria to be able to take advantage of Exit’s services in nursing homes across the canton.

The initiative requires that a patient have a serious or terminal disease, and be judged competent to make decisions. In addition, the new law will require that the patient be fully informed about the availability of palliative care.

“There was clearly a risk of trivializing suicide,” cantonal health minister and proponent of the counter-initiative, Pierre-Yves Maillard, said of Exit’s proposal.

“If we had not launched a counter-proposal, the debate would have taken place between supporters of Exit and people whose minds were closed to assisted suicide. This debate has led to a successful initiative,” he told newspaper Tribune de Genève

Not everyone agrees however, and those with conscientious objections are concerned.

“It’s still not right that the law requires us to act contrary to our conscience,” Jacques Chollet, chairman of the boards of trustees of Praz-Sun and Bethel nursing homes, told the newspaper.

According to Maillard, employees who do not cooperate with the new regulations will first be given a warning before “appropriate sanctions” are applied.

Although disappointed by the failure of their own initiative, Exit supporters are pleased with the result.

It’s a “half-step in the right direction,” chief of Exit Romandie told Tribune de Genève.

Up until now, Exit has faced an administrative battle each time it has sought to assist a patient.

Using a legal loophole, the organization has been able to operate because its work is not carried out for selfish ends. Unlike family members, which could potentially be seen as having selfish motives behind assisting, Exit has greater freedom to act due to its lack of proximity to its patients.

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Switzerland: What is the difference between assisted suicide and euthanasia?

While the terms often are used interchangeably, assisted suicide and euthanasia - and the laws that govern them - are quite different. Here’s what you need to know.

A person in a medical coat holds hands with another
Euthanasia and assisted suicide might be spoken of in the same breath, but they are quite different. Here's what you need to know. Photo by Matheus Ferrero on Unsplash

The terms assisted suicide, assisted dying and euthanasia are often used interchangeably – even by media and politicians covering the matter. 

There are however some key differences, both in terms of the legal situation and the practice itself. 

Assisted suicide is where a medical professional, usually a doctor but sometimes a pharmacist or other specialist, provides some form of medication to assist a patient as they commit suicide. 

EXPLAINED: How foreigners can access assisted suicide in Switzerland

Crucially, it is the patient who takes the final step, i.e. by taking a medication or by pressing a switch through which the medication is administered. 

Euthanasia on the other hand is where the medication which ends someone’s life is administered by a doctor or medical professional. 

Euthanasia is sometimes known as voluntary euthanasia, which references the fact that the patient volunteers for the process by providing consent. 

Other forms of medical intervention which lead to death – for instance turning off life support for someone who has been in a long-term coma – do not fit within the definition of voluntary euthanasia. 

The term ‘assisted dying’ is used as a grouping term to refer to both assisted suicide and euthanasia, although media sources – particularly in the United Kingdom – often use assisted dying when referring primarily to assisted suicide. 

What are the rules for assisted suicide and euthanasia in Switzerland? 

The law in Switzerland recognises the distinction between assisted suicide and euthanasia. 

Euthanasia is not permitted under law in Switzerland, while assisted suicide is allowed for both locals and foreigners. 

While article 115 of the Swiss penal code prohibits assisted suicide for “self-serving reasons” and article 114 prohibits “causing the death” of a person for “commendable motives, and in particular out of compassion for the victim”, assisted suicide for non-selfish reasons is not specifically prohibited as long as certain conditions are met. 

The Swiss supreme court has ruled the following: people must commit suicide by their own hand, for example, by taking medication themselves. A doctor cannot administer a lethal injection without being liable for criminal prosecution.

People must also be aware of actions they are undertaking and have given due consideration to their situation. In addition, they be consistently sure they wish to die, and, of course, not be under the influence of another person, or group of persons.

READ MORE: What you need to know about assisted suicide in Switzerland

Several other jurisdictions across Europe and the globe also make a legal distinction between the two, although euthanasia is legal in some countries including the Netherlands, Belgium, Luxembourg and Columbia. 

What is the medical procedure involved?

Most Swiss associations request that patients drink sodium pentobarbital, a sedative that in strong enough doses causes the heart muscle to stop beating.

Since the substance is alkaline, it burns a bit when swallowed.

A professional prepares the needle, but it is up to the patient to open the valve that allows the short-acting barbiturate to mix with a saline solution and begin flowing into their vein.

A video is shot of the patient stating their name, date of birth and that they understand what they are about to do. The camera keeps rolling as they open the valve and the footage is used as evidence that they willingly took their own life.

It usually takes about 20 to 30 seconds for the patient to fall asleep.