assisted suicide For Members

How were two healthy American sisters able to take their own lives in Switzerland?

Helena Bachmann
Helena Bachmann - [email protected]
How were two healthy American sisters able to take their own lives in Switzerland?
Assisted suicide in a Swiss clinic is legal under certain conditions. Photo by Bret Kavanaugh on Unsplash

An unresolved mystery is surrounding the death of two healthcare workers from the US state of Arizona who reportedly came to Switzerland for a vacation but never returned home. This is what the authorities say happened to them.


As reported in the US media on Tuesday, the sisters, Lila Ammouri, 54, and Susan Frazier, 49, a doctor and nurse, took a trip to Switzerland on February 3rd, telling everyone they were going on vacation.

But when they didn’t return on their February 13th flight home, their family and friends began to worry.

After the US State Department got involved in the mystery disappearance, it turned out the two women, who were reportedly healthy and happy, died by assisted suicide in a Basel clinic — a plan they kept secret from everyone.

This information was confirmed by the Basel-Country’s public prosecutor's office.


More questions than answers

The question of why the sisters chose to die and why they came all the way to Switzerland to do so when nine US states allow assisted suicide may remain unanswered.

While the women’s friends and family believe foul play was involved in their death, Basel’s prosecutor said no criminal investigation has been launched as the assisted suicide took place “within the legal framework” and no crime was committed.

That’s because Swiss legislation permits assisted suicide under certain conditions: if the patient is over the age of 18, mentally and physically capable of making the decision to die, and administers the drug him/herself  in a private residence.

Also, the person assisting in the suicide must not have any selfish motives.

If a third party administers the drug, the act is considered euthanasia, which remains illegal here.

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

Membership and paperwork

A sign that the sisters had been planning their death in Switzerland for a while is that it is not possible for anyone to just walk into a clinic and ask to be put to death right there and then (as gruesome as it sounds).

The process includes making first contact (either directly or through a family member), personal interviews, counselling, and loads of paperwork. It can take three months or longer, as it involves becoming a member of a right-to-die organisation and paying all the administrative fees — amounting to several thousand francs — for cremation and other expenses, upfront. A prescription for lethal medication will then be ordered from a doctor.

There is even more paperwork involved when foreigners choose assisted suicide in Switzerland and this can be time-consuming as well.

To ensure that the process complies with the law, 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 that allows a barbiturate to begin flowing into their vein. This footage is used as evidence that they willingly took their own life.

That Basel authorities are not filing charges in the case of the two sisters implies that all processes leading to their death complied with the rules.


Can healthy people choose to die this way?

Neither Ammouri nor Frazier reportedly suffered from terminal or incurable medical conditions, so why were they allowed to commit suicide?

Only three conditions have to be fulfilled for assisted suicide in Switzerland: the person wishing to die has to have her/his decisional capacity; opens the valve him/herself, and the assisting person must have no selfish motive.

No specific restrictions relating to the ground of suffering are mentioned in the law.

While some organisations, like Exit, apply stricter criteria to the notion of illness and suffering — for instance, the patient has no chance of recovery, or lives with chronic and unbearable pain or disability — Swiss legislation in this matter doesn’t specifically apply to physical illness.

Mental distress, also defined as “existential suffering”, while decidedly a bit of a grey area that lacks definition, also falls under the “suffering” category.

According to a report co-authored by two Geneva medical ethicists, “suffering is surely not limited to disease status. If we consider relief from suffering to be one of the central considerations for assisted suicide, it is reasonable to think that the acceptability of a request should not exclusively depend on the diagnosis of an incurable or terminal disease”.

For instance, one of the Swiss right-to-die organisations, Pegasos — reportedly the clinic where the sisters died — says on its website it “believes that for a person to be in the headspace of considering ending their lives, their quality of life must be qualitatively poor. Pegasos accepts that some people who are not technically 'sick' may want to apply for assisted suicide”.

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





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