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What you need to know about assisted suicide in Switzerland

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What you need to know about assisted suicide in Switzerland
The Dignitas centre in Pfäffikon, canton Zurich. File photo: AFP
12:20 CEST+02:00
With Australian scientist David Goodall set to end his life in Switzerland on Thursday, we take a look at how assisted suicide works in the alpine country.

Australia’s oldest scientist, 104-year-old David Goodall, is planning to end his life in Switzerland today.

Although Goodall does not have a terminal illness, his quality of life has deteriorated seriously in recent years and he wants to die.

Read also: Assisted suicide increasingly popular in Switzerland

Goodall is a long-term member of Exit International, an organisation which fights for people's rights to choose how they wish to die. But as most Australian states prohibit assisted suicide – except for Victoria where it is allowed only in cases of terminal illness – Goodall was forced to come to Switzerland.

Here we take a look at what you need to know about assisted suicide in Switzerland.

Is assisted suicide legal?

The short answer is yes, by omission.

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 (see below).

Police inquiries can follow an assisted suicide and prosecutors may take action if they feel a crime has been committed. However, Swiss suicide assistance organisation Exit notes on its website that autopsies are rarely performed after assisted suicides.

What are the conditions for assisted suicide?

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.

Who helps people to commit suicide in Switzerland?

The main associations are Exit, Dignitas, Ex International, and lifecircle – the association that David Goodall has an appointment with.

Exit and Dignitas are the largest groups in Switzerland. Exit only provides assistance for citizens or long-term residents of Switzerland while Dignitas provides assisted suicide services to foreigners as well.

How does the paperwork process work?

The different associations have slightly different procedures but both Exit and Dignitas stress that it is not possible to simply walk in off the street, collect the necessary medication and commit suicide. Dignitas, for example, says the process can take three months or longer.

For both organisations, people wishing to use their services must be members. Dignitas specifies that for non-members, submission of a declaration of membership is a mandatory first step although it also notes there is no waiting period between become a member and applying for assisted suicide.

Beyond that, Dignitas and Exit outline processes that include making first contact (either directly or through a family member), counselling and personal interviews, submission of medical documents and an exploration of other treatment options including palliative care. A prescription for lethal medication will then be ordered from a doctor.

Dignitas also notes there is a lot of paperwork involved when foreigners choose assisted suicide in Switzerland and this can be time-consuming.

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 and 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.

How many people use assisted suicide services in Switzerland?

More and more: a total of 956 (539 women and 426 men) people made use of these services in 2015 according to official figures, up from 187 in 2003. There is a steadily rising trend, although assisted suicides are still only a tiny proportion of all deaths in Switzerland.

Exit said 734 people committed suicide using its services in 2017 and noted its membership was now up to 110,391.

How much does assisted suicide cost?

Beyond the Dignitas membership costs (200 francs for a one-off joining fee, or 80 francs a year), people wishing to pursue assisted suicide must pay an upfront 4,000-franc fee, without any guarantee this suicide will go ahead.

A further 1,000 francs must be paid for medical consultations and the writing of the prescription for medication required.

Finally, if assisted suicide goes ahead, another 2,500 francs is charged to cover Dignitas costs, according to their website.

Dignitas can also organise funerals and oversee administrative affairs.

The total cost is therefore 7,500 francs without funeral and administrative services and 10,500 francs with those services – usually payable in advance.

But is should be noted Dignitas can waive some or all costs for people in financial difficulties.

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