On June 6, 2018, the Swiss Academy of Medical Sciences (“ASSM”), updated and revised the 2004 guidelines for their “Position on the End-of-Life and Death“. One of the directives given by this organization, responsible for establishing ethical regulations for Swiss health professionals is intended to ease medical stipulations for assisted suicide.
Previously, Swiss doctors could only prescribe lethal substances for patients facing imminent death. With the new “end-of-life” stipulations, doctors will be able to propose assisted suicide to their patients enduring “unbearable suffering due to symptoms from their disease and / or functional limitations”. This new criterion will comes in replacement of the “end of life” criterion.
With more than 40,000 members and federating over 70 medical organizations, the Federation of Swiss Doctors (“FMH”), is opposed to the new guidelines. Their president, Jürg Schlup, declared: “this new guideline is vague and could lead to misinterpretations within the Deontology Commission. This is particularly serious for such an irreversible decision.” This new version for the code of ethics may not be recommended even though the association is determined to carefully examine the situation.
Samia Hurst, as member of the sub-commission who drafted these end-of-life guidelines, admits that “unbearable suffering” is subjective. “After taking the patient’s case history into account and examining the patient on numerous occasions, the doctor must determine if the suffering is indeed unbearable. Regardless of his conclusions, the doctor still has the right and freedom to refuse to provide suicide assistance. He remains free to do so. It cannot be imposed upon him. “
The Bioethics Committee of the Swiss Bishops’ Conference pointed out a very serious switch in these new guidelines because they are in absolute contradiction with current medical ethics and even alter the purpose of medicine itself. Every single caregiver would be in a position to decide whether assisted suicide “is medically indicated or not“. Until now, the guidelines unequivocally stated that assisted suicide was not defined as a medical activity since “it is contradictory to medical objectives“.
In the past few years, the number of assisted suicides has risen sharply in Switzerland. The Swiss Health Observatory notes that “Compared to other countries, and to other health problems, in Switzerland, death by suicide is an often underestimated public health problem. In Europe Switzerland has an above-average suicide rate.”
Recall: Under certain conditions, assisted suicide is allowed in Switzerland, under Penal Code, Article 115, which prohibits encouraging or assisting suicide for “selfish reasons“. Euthanasia remains unlawful.
The Confederation has recognized the ASSM, i.e. the Swiss Academy of Medical Sciences, as “an institute for promoting research”. It is namely in of the task of examining ethical issues. The Central Ethics Commission of the ASSM defines medico-ethical guidelines which are usually added to the Swiss Federation of Medical Practitioners’ Code of Ethics.