“suicide tourists

The number of people traveling to Switzerland to commit suicide has doubled since 2009, a new study shows.

These” are largely from Germany and the United Kingdom, although they also come from other countries including the United States and Canada, and nearly half suffer from nonfatal neurological conditions, such as paralysis, motor neurone disease, Parkinson’s disease, and multiple sclerosis, the study suggests.

Saskia Gauthier, MD, from the Institute of Legal Medicine, University of Zurich, and colleagues report their findings in an article published online  August 20 in the Journal of Medical Ethics.

Assisted suicide is restricted in many countries, but in Switzerland it is not clearly regulated by law, leading to an influx of people coming to the country, mainly to the Canton of Zurich, for the sole purpose of ending their lives, the authors say. “Swiss medicolegal experts are confronted with cases almost daily, which prompted our scientific investigation of the phenomenon,” the authors note.

The researchers searched the databases of the Institute of Legal Medicine in Zurich on assisted suicide and found that 611 non-Swiss residents had been helped to die between 2008 and 2012. All but 4 were helped by Dignitas, 1 of 6 right-to-die organizations active in Switzerland.

These ‘suicide tourists’ ranged in age from 23 to 97 years (median, 69 years). More than half (58.5%) were women, who were 40% more likely to choose assisted suicide in Switzerland than men. In all but 4 cases, assisted suicides were carried out with sodium pentobarbital.

Neurological diseases were the reason for assisted suicide in nearly half of cases (47.4%), followed by cancer (37.2%), rheumatic disease (24.6%), cardiovascular disease (15.2%), mental disorder including dementia (3.4%), and HIV (1.3%).

“These results imply that that non-fatal diseases or diseases that are not yet end stage (ie, not meeting the criteria required for Swiss doctors) are more often becoming the reason for seeking [assisted suicide],” the authors note. However, they urge caution in interpreting these data, given that 28% of the group had more than 1 disease.

People seeking assisted suicide during the study period came from 31 different countries, with German and UK nationals making up nearly two thirds of the total, with 268 and 126 cases, respectively.

Other countries in the top 10 included France, with 66 cases; Italy, with 44; the United States, with 21; Austria, with 14; Canada, with 12; and Spain and Israel, with 8 each.

The increase in people seeking assisted suicide in Switzerland was particularly steep in Italy, increasing from 4 cases in 2009 to 22 in 2012, and France, increasing from 7 cases in 2009 to 19 in 2012.

Overall, 2009 to 2012 saw a doubling in the numbers of people being helped to end their lives in Switzerland, going from 86 in 2009 to 172 in 2012, the researchers say.

This study shows that the “phenomenon of suicide tourism has been growing over the years and is still increasing unabated,” they conclude.

The study was funded by the Swiss National Science Foundation. The authors have no relevant disclosures.

J Medical Ethics. Published online August 20, 2014. Full text

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