Assisted Suicide in Switzerland: The 10-Year Experience of a Palliative Care Unit Medical Director and Ethic Committee Member (FR412)

Abstract

1.Review the definition and history of physician-assisted suicide (PAS) and describe its various developments, both in the United States and Europe.2.Explore Switzerland's unique situation regarding assisted suicide (AS).3.Identify and discuss the arguments in support of/in opposition to PAS/AS based on practical, ethical, social, cultural, and spiritual considerations. The Netherlands has been considered the origin of the Death with Dignity movement, which supports allowing a physician to make a lethal prescription available to terminally ill patients who request it, namely PAS. This movement has spread to several countries in Europe and some areas of the United States. In all of these, safeguards and laws have been put in place to prevent abuse and misuse of these practices. Switzerland is in a unique situation, as it is the only country where the law limits the circumstances in which AS is a crime. AS is commonly performed with the assistance of right-to-die organizations and does not require the involvement of a physician. A great deal of media attention and concern has been raised in the past decade due to the practice of a specific organization (Dignitas) that offers AS to nonresident foreigners, now labeled “death tourism.” In the French part of Switzerland, another right-to-die organization (Exit) fought to have AS provided in nursing homes. This has caused various ethics committees to start heated debates on this controversial topic. Several nursing homes and one hospital group, which included a palliative care unit, chose to adopt this AS practice under strict criteria. In 2006, the University Hospital of Lausanne became the first Swiss academic center to allow AS within its walls. These decisions posed ethical and practical dilemmas to the palliative care unit and the palliative care consult service team members of these institutions. Using clinical vignettes as well as a thorough review of the literature, this presentation aims to explore the various dimensions (practical, ethical, social, cultural, and spiritual) of this sensitive topic, and to review in an interactive way the arguments potentially in support of/in opposition to PAS/AS.