San José, Costa Rica, since 1956
Switzerland

Suicide option draws 'tourists' to Switzerland

It’s a tourism boom, but not one to crow about: The number of people traveling to Switzerland to end their lives is growing. And it seems that more and more people with a nonfatal disease are making the trip.

An ongoing study of assisted suicide in the Zurich area has found that the number of foreign people coming to the country for the purpose is rising. For example, 123 people came in 2008 and 172 in 2012. In total, 611 people came over that period from 31 countries, mostly from Germany and Britain: 44 percent and 21 percent of the total, respectively. Twenty-one people came from the United States. The study found that the median age for what it termed “suicide tourism” was 69 years, and just under 60 percent were women.

Neurological diseases, only some of which are fatal, were given as the reason for 47 percent of those foreign cases, up from 12 percent in a similar study of the same region between 1990 and 2000. Rheumatic or connective tissue diseases, generally considered nonfatal and including such ailments as rheumatoid arthritis and osteoporosis, accounted for 25 percent of cases in the new study. Between 1990 and 2000, they were cited in only 10 percent of cases.

There was also a tiny rise in the proportion of people coming to Switzerland for assisted suicide because of mental health problems: 3.4 percent in the latest study, up from 2.7 percent. Cancer, on the other hand, was cited in 37 percent of cases between 2008 and 2012, a decrease of 10 percent.

The researchers write that the figures suggest that nonfatal diseases and illnesses that can be terminal but have yet to reach their final stages could be becoming increasingly common reasons to seek assisted suicide, though they also note that the earlier study looked at Swiss residents, whereas theirs looks only at foreign visitors.

One reason that people with non-terminal conditions might be traveling to Switzerland to die could be that people with late-stage diseases are less mobile, according to Michael Charouneau of the British group Dignity in Dying. “We know that many of those who travel do so earlier than they would wish, whilst they are still physically well enough to make the journey,” he said.

“The idea of assisted suicide is more acceptable today than it was 10 or 20 years ago,” says Ruth Horn, a medical ethics researcher at the University of Oxford. She suggests that this might be one reason why more people with nonfatal diseases are choosing to end their lives. “Subsequently it appears to have become more and more acceptable to extend the right to assisted death to patients with non-terminal conditions.”

Also, the study’s authors point out, “In Switzerland, assisting suicide is not clearly regulated by law and unlike in other countries [where it is legal] such as the Netherlands or certain states of the USA, for example, Oregon, no rules exist that regulate under which conditions someone might receive assisted suicide.”

In addition to Oregon, physician-assisted suicide is legal in Washington state, Montana, and Vermont for adults who are residents of those states. (It is also available in one county of New Mexico, where legal skirmishing continues.) The issue is currently under debate in New Jersey.

Euthanasia has been debated in Germany and Britain in recent years. While efforts to change Germany’s criminal code have stalled, a bill on assisted suicide is being debated in Britain’s House of Lords. “People choosing to go to Switzerland for assistance to die is one signal that the law is not working here,” Charouneau said.

This story was produced by New Scientist magazine.

© 2014, New Scientist

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