What are the rules on euthanasia and assisted suicide in Switzerland?

When France debates the very sensitive issue of the end of life, the subject in Switzerland is appeased after long years of practice.

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The Swiss country offers palliative medicine measures, but also tolerates forms of euthanasia and organized assistance with suicide. Under certain conditions.

These practices are governed by codes of medical ethics and organizations such as EXIT and Dignitas, which have enacted their own safeguards (age, illnesses, etc.).

Direct active euthanasia – the doctor or a third party intentionally injects the patient with a direct result in his death with the aim of ending his suffering – is prohibited.

On the other hand, indirect active euthanasia (use of substances, such as morphine, the side effects of which can reduce the duration of survival) is admitted by the directives of the Swiss Academy of Medical Sciences, even if it is not expressly regulated in the Penal Code.

Passive euthanasia – renunciation of the implementation of life-sustaining measures or termination of these, for example the disconnection of an oxygen apparatus – is also not punishable, even if this form of euthanasia is not expressly regulated by law either. In practice, doctors prefer to speak of “therapeutic withdrawal”.

The best-known of assisted death practices remains assisted suicide, which has been on the increase for several years, which is authorized under certain conditions and organized by civil society associations.

The volunteer companions of these associations provide the patient with the deadly substance – obtained through a medical prescription – which he will ingest himself, without outside intervention, to end his life. A doctor must certify the death.

The person must be of legal age, capable of discernment, be affected either by an incurable disease, or by intolerable suffering, or by disabling polypathologies linked to age.

After several in-depth analyzes of the situation, the Swiss government came to the conclusion in 2011 that a specific criminal standard on organized assistance in suicide was not necessary.

Only someone who, “driven by a selfish motive”, assists in the suicide of someone (for example by providing him with a deadly substance) is punishable, according to the Penal Code, by a custodial sentence of up to five years. or a monetary penalty.

In 2021, around 1,400 people used the service of EXIT Deutsche Schweiz and EXIT Suisse romande (973 in the German- and Italian-speaking regions and 422 in the French-speaking region) and around 200 those of Dignitas.

The procedure generally takes place at the person’s home or at the home of a relative. In some cantons, it can also take place in an establishment for the elderly or in a medical establishment with the agreement of the latter.

Some hospitals authorize the arrival of associations offering assisted suicide, under very strict conditions.

In the canton of Geneva, the Geneva University Hospitals (HUG) only authorized assisted suicide within their walls when the patient was homeless or unable to return home. The new provisions taken in 2019, implemented since July 2022, have made it possible to extend assisted suicide in hospital to people with a home. However, it is the associations that travel to the HUG to assist the patient in his last moments.

Discussions have also taken place in recent years on assisted suicide for sick prisoners, but they have not yet resulted in any legislation.

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