Traveling to Switzerland to die, the death tourism boom

In July of 2009, Lady Joan Downes, the wife of famous English opera conductor Sir Edward Downes, sent a letter to her family explaining she was diagnosed with terminal pancreatic cancer and would not be seeking treatment.

“It has been a happy and interesting life and I have no regrets,” the letter stated. A few weeks later she and her husband traveled to Zurich, Switzerland where they paid $11,000 to end their lives in an apartment operated by an assisted dying group called Dignitas. The couple took an antiemitic to prevent nausea then drank fruit juice spiked with Nembutal, a central nervous system depressant which brings on drowsiness and sleep. Their breathing became shallow, they entered a coma and within half an hour they were dead.

Twenty three Britons traveled to Switzerland to die at Dignitas last year, one of four places in Switzerland where sick people can end their lives. And 400 a year do, about one-third of them foreigners. A British law against assisted suicide carries with it a prison sentence of up to 14 years. But change is in the air. “The current law does not match the requirements of the 21st century,” Pauline Smith, the end-of-life care lead for Britain’s West Midlands region, stated a few weeks ago. “If you can afford to go to Switzerland that’s fine but if you can’t, you are stuck within a system that doesn’t really allow you to talk about it, never mind have access to it.”

Even family members who help pay for a loved one’s trip to Switzerland to die are culpable under the current law. Last year, the British Home Office released a statement to travelers: “Section 2(1) of the Suicide Act 1961 makes it an offence in this country to aid, abet, counsel or procure somebody to commit suicide…we believe that the offence under section 2(1) is committed even where the suicide occurs abroad.”

Assisted suicide is legal in Switzerland but illegal across much of the rest of Europe (only the Netherlands, Luxembourg and Belgium allow it), which has led to a boom in “death tourism”, people traveling to Switzerland to die. As of 2008, 840 people had ended their lives with Dignitas and hundreds more have died at Switzerland’s three other assisted dying facilities. Some Swiss politicians worry that their nation’s bucolic image is being tarnished, they aim to stem the flow by heavily taxing death tourists, or making assisted suicide illegal. “We have no interest in being attractive for suicide tourism,” the Swiss justice minister told reporters in 2009.

Critics claim Switzerland’s assisted suicide law is weak and that the industry is unregulated. Under Swiss law, assisted suicides can only be prosecuted if it can be proved they are “motivated by self-interest”. Dignitas has faced criticism over everything from their fees to their means (for a time, helium was used instead of Nembutal ingestion, but was stopped because it caused shaking and twitching) to the sometimes sordid places where people die.

One law proposed by the Swiss cabinet last year calls for an outright ban on assisted suicide. Another is more moderate, allowing assisted suicide to continue but demanding tighter regulations. Patients would need to obtain two medical opinions proving their illness was incurable and probably fatal within months. Doctors would also have to verify that the dying person had the mental capacity to declare their desire to die and that they had held this wish for some time. Assisted dying groups would have to provide better records, a measure meant to stop groups from profiting on patients desire to die. Critics also want assisted suicide to be restricted to the terminally ill and not be available to chronically or mentally ill individuals. “Assisted suicide is a death project,” explained one Swiss official. “I support life projects.”

Daniel Gall, a French voice-over actor, traveled to Switzerland to be with his 81 year-old sister who said she could no longer face the Alzheimer’s she was suffering from. She, and her 86 year-old husband, died in a Dignitas apartment in January of 2008. Gall was appalled by the setting and came away feeling queasy about the idea of assisted suicide for the non-terminally ill. “It seemed like a factory,” he said. “It was an awful, ugly place…Everyone should have the right to decide about his death. But it shouldn’t be possible to help people who are not sick die. Assisted suicide should be a last resort.”