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J Med Ethics 34:810-814 doi:10.1136/jme.2007.023887
  • Research ethics

Suicide assisted by two Swiss right-to-die organisations

  1. S Fischer1,
  2. C A Huber1,
  3. L Imhof1,
  4. R Mahrer Imhof1,
  5. M Furter2,
  6. S J Ziegler3,
  7. G Bosshard4
  1. 1
    School of Health Professions, Zurich University of Applied Sciences, Switzerland
  2. 2
    University Children’s Hospital, Zurich, Switzerland
  3. 3
    Indiana University-Purdue University, Fort Wayne, Indiana, USA
  4. 4Institute of Legal Medicine, University of Zurich and Institute of Biomedical Ethics, University of Zurich, Zurich, Switzerland
  1. Dr S Fischer, Center for Health Sciences, School of Health Professions, Zurich University of Applied Sciences, PO Box, CH-8401 Winterthur, Switzerland; Susanne.Fischer{at}zhaw.ch
  • Received 27 November 2007
  • Revised 31 January 2008
  • Accepted 7 February 2008

Abstract

Background: In Switzerland, non-medical right-to-die organisations such as Exit Deutsche Schweiz and Dignitas offer suicide assistance to members suffering from incurable diseases.

Objectives: First, to determine whether differences exist between the members who received assistance in suicide from Exit Deutsche Schweiz and Dignitas. Second, to investigate whether the practices of Exit Deutsche Schweiz have changed since the 1990s.

Methods: This study analysed all cases of assisted suicide facilitated by Exit Deutsche Schweiz (E) and Dignitas (D) between 2001 and 2004 and investigated by the University of Zurich’s Institute of Legal Medicine (E: n = 147; D: n = 274, total: 421). Furthermore, data from the Exit Deutsche Schweiz study which investigated all cases of assisted suicide during the period 1990–2000 (n = 149) were compared with the data of the present study.

Results: More women than men were assisted in both organisations (D: 64%; E: 65%). Dignitas provided more assistance to non-residents (D: 91%; E: 3%; p = 0.000), younger persons (mean age in years (SD): D: 64.5 (14.1); E: 76.6 (13.3); p = 0.001), and people suffering from fatal diseases such as multiple sclerosis and amyotrophic lateral sclerosis (D: 79%; E: 67%; p = 0.013). Lethal medications were more often taken orally in cases assisted by Dignitas (D: 91%; E: 76%; p = 0.000). The number of women and the proportion of older people suffering from non-fatal diseases among suicides assisted by Exit Deutsche Schweiz has increased since the 1990s (women: 52% to 65%, p = 0.031; mean age in years (SD): 69.3 (17.0) to 76.9 (13.3), p = 0.000), non-fatal diseases: 22% to 34%, p = 0.026).

Conclusions: Weariness of life rather than a fatal or hopeless medical condition may be a more common reason for older members of Exit Deutsche Schweiz to commit suicide. The strong over-representation of women in both Exit Deutsche Schweiz and Dignitas suicides is an important phenomenon so far largely overlooked and in need of further study.

Footnotes

  • Funding: The present study was supported by grants from the Swiss National Science Foundation (SNSF) and the Swiss Academy of Medical Sciences (SAMS). The work of all authors was independent of the funders.

  • Competing interests: None declared.

  • Ethics approval: This study was approved by the Ethics Committee of the Canton of Zurich.