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EUTHANASIA

How do Switzerland’s rules on assisted suicide compare across Europe?

As Austria sets out its plan for legalising assisting suicide from 2022 in response to a court ruling, we look at how this compares to other countries' legislation on euthanasia and assisted suicide - including that from Switzerland.

People holding hands in a hospital bed
Switzerland has had rules in place which legalise assisted suicide for decades. What is the situation across Europe? Photo by Jon Tyson on Unsplash

Assisted suicide has been legal in Switzerland since the 1980s. With news emerging yesterday that Austria will adopt similar rules, here is the legal situation and how it compares to other European countries.

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

What are the new plans in Austria? 

According to a summary of the proposed legislation from the Austrian justice ministry, adults who are terminally ill or suffer from a permanent and debilitating condition will be able to access help with ending their own lives.

Two doctors will have to assess each case, one of whom will have to be qualified in palliative medicine.

Among their duties will be to determine whether the patient is capable of coming to the decision independently.

In addition, at least 12 weeks will have to pass before access is granted to make sure euthanasia is not being sought due to a temporary crisis.

READ ALSO: Austria sets out plans for legalising assisted suicide

Where is it fully legal in Europe?
The Netherlands legalised active and direct euthanasia in 2002.

Lethal doses of drugs are authorised if patients make the request while lucid.

They must also be experiencing unbearable suffering from a condition diagnosed as incurable by at least two doctors.

Last year, the country’s highest court ruled that doctors would be able to conduct assisted suicides on patients with severe dementia without fear of prosecution, even if the patient no longer expressed an explicit death wish.

The Netherlands also moved towards making euthanasia legal for terminally ill children aged between one and 12.

EXPLAINED: How foreigners can access assisted suicide in Switzerland

Belgium lifted restrictions on euthanasia in 2002 for patients facing constant, unbearable and untreatable physical or psychological suffering.

They must be aged 18 or over and request termination of life in a voluntary, reasoned and repeated manner, free from coercion.

In 2014, Belgium became the first country to authorise children to request euthanasia if they suffer a terminal disease and understand the consequences of the act.

In Luxembourg a text legalising euthanasia in certain terminal cases was approved in 2009. It excludes minors.

Read also: Assisted suicide increasingly popular in Switzerland

In Spain, the Spanish parliament voted through a law allowing euthanasia under strict conditions on Thursday March 8th, so terminally ill or gravely injured patients could end their own suffering.

The law came into effect in June 2021, making it the fourth European country to decriminalise euthanasia.

Swiss exception
Switzerland is one of the rare countries that allows assisted suicide with patients administering a lethal dose of medication themselves.

It does not allow active, direct euthanasia by a third party but tolerates the provision of substances to relieve suffering, even if death is a possible consequence.

More information about the rules in place in Switzerland can be found at the following link. 

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

Australian scientist David Goodall (C) leaves in a wheelchair after a press conference on May 9th, 2018, on the eve of his assisted suicide in Basel. He was barred from seeking help to end his life in Australia, so he was forced to travel to Switzerland. Photo: SEBASTIEN BOZON/AFP

Decriminalisation attempt blocked in Portugal
In March, Portugal’s top court rejected a law decriminalising euthanasia that had been approved by parliament in January saying it was too imprecise.

The bill, which would have legalised access to assisted suicide for adult patients in a situation of “extreme suffering and irreversible damage”, now goes back to parliament for a possible amendment.

Italian compromise
Italy’s Constitutional Court ruled in 2019 it was not always a crime to help someone in “intolerable suffering” commit suicide. Parliament is set to debate a change in the law banning the practice.

The halting of medical procedures that maintain life, called passive euthanasia, is also tolerated.

In August 2021, more than 750,000 people in Italy signed a petition calling for the legalisation of euthanasia, exceeding by far the half-a-million threshold needed to force a referendum on the issue.

A vote could be held as early as next year on the campaign, which calls for changes to the country’s laws on assisted dying.

Centenarian Helene Wuillemin, seen here at her flat in Laxou, eastern France, went on hunger strike after her applications for euthanasia in Switzerland and Belgium were rejected. Photo :JEAN-CHRISTOPHE VERHAEGEN/AFP

‘Right to die’
In France, a 2005 law legalised passive euthanasia as a “right to die”. A 2016 law allows doctors to couple this with “deep and continuous sedation” for terminally ill patients, while keeping euthanasia and assisted suicide illegal.

In April 2021, a bill to legalise euthanasia could not be voted on as planned due to the number of amendments submitted.

Sweden authorised passive euthanasia in 2010 and Ireland also recognises the “right to die”.

Britain has allowed medical personnel to halt life-preserving treatment in certain cases since 2002. Prosecution of those who have helped a close relative die, after clearly expressing the desire to end their lives, has receded since 2010.

In Germany, passive euthanasia is permitted if requested by the patient. In January 2021, the country’s parliament proposed new legislation that would allow assisted suicide for terminally ill adults once they have received counselling.

Refusing treatment
Denmark has allowed people to file written refusal of excessive treatment in dire situations since 1992, with the document held in a centralised register.

In Norway, passive euthanasia is permitted if requested by the patient or by a relative, if the patient is unconscious.

In Hungary, people with incurable diseases can refuse treatment.

It is also legal to end treatment for terminally ill people in Lithuania and Latvia.

Member comments

  1. The horrors of having to watch family members dying in agony are unspeakable and don’t need repeating here.
    What is less often discussed are the degrees of openness with which doctors, patients and, again, family members confront the impending death of someone close to them.
    Nearly as bad is being faced with a loved one lying helplessly in bed wanting to do nothing other than sleep and seeing no point to life any more, pleading to be allowed to die. We should all be ready to talk in good time about how we envisage our future and discuss our wishes with family and friends, if nothing else to ensure that we are not forced against our will to live on helplessly.
    There are many good books focussing on how to deal with planning the future. I would recommend three, very different ones, all of them thought-provoking without being heartbreakingly emotional and sentimental. First, the new novel by Lionel Shriver, ‘Should we stay or should we go’, second, Ueli Oswald’s memoir, ‘Exit — The last year with my father’ and thirdly Guy Kennaway’s, ‘Time to go’.

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EUTHANASIA

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.

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