Swiss legalised assisted suicide in 1937
Assisted suicide has been legal in Switzerland since 1937 and is specifically dealt with by articles in the country's penal code. However, doctors are prohibited by the Swiss Academy of Medical Sciences from professionally participating in assisted suicide.
Since the early 1980s, four organisations, Exit Switzerland, Exit International, Dignitas and Exit/ADMD, have been formed with the purpose of helping individuals seeking assisted suicide.
Dignitas, based in Zurich and headed by a lawyer, Ludwig Minelli, helps members who are foreigners. The organisation has over 2,000 members, many of whom live outside Switzerland. Founded in 1998, it is estimated that the organisation - whose slogan is "Live with dignity, die with dignity" - has assisted over two dozen British people to end their lives. While details of its membership in the Republic are unknown, it is thought that Dignitas has over 500 members in the UK.
Article 115 of the Swiss Penal Code considers assisting suicide a crime if and only if the motive is a selfish one. It condones assisting suicide for altruistic reasons. Article 115 does not require the involvement of a physician nor that the patient be terminally ill. The right to die organisations inform the Swiss police when an assisted suicide has taken place. Prosecution only occurs if there is a doubt as to the patient's competence to make an independent choice to die. The Swiss Academy of Medical Sciences states in its ethical code that assisted suicide is "not part of a physician's activity".
This somewhat ambiguous statement is usually understood to mean that physicians should not assist suicide; however, it has also been interpreted as referring Swiss doctors to their role as ordinary citizens.
Legally, this would leave them with the same discretion as any citizen to altruistically assist suicide. Dignitas is known to have assisted a British couple, Robert and Jennifer Stokes, in 2003. Neither was thought to be terminally ill, but were suffering from psychological illness and chronic disease.
One of the first Britons to receive help from the organisation was Reginald Crew, a 74-year-old man with motor neurone disease. He died in January 2003.
Some 91 foreign nationals are thought to have died in 2003 with the help of Dignitas.
This growth in "suicide tourism" has led to concern among authorities in Zurich. It has been suggested that non- Swiss should have to live in Switzerland for six months or more before they are eligible for assisted suicide.
At present, most foreign patients spend only 24 hours in the country, leading to concern that each case cannot be checked adequately to ensure the person has an established commitment to end their own lives.
Dignitas has indicated that it might challenge any new regulations, which would mean the patient providing medical reports from two separate doctors as well as a certificate proving their mental competence.
Apart from its unique stance on assisted suicide, Switzerland is unusual in that it does not recognise euthanasia, which is legal in certain circumstances in Holland, Belgium and the US state of Oregon.