Will Switzerland allow assisted suicide for its prisoners?

A request by a convict behind bars for life is testing Switzerland's support for assisted suicide, raising complex questions over whether ill prisoners can seek help to end their own lives.

Will Switzerland allow assisted suicide for its prisoners?
The prison of Bois-Mermet is seen on November 18, 2019 in Lausanne, western Switzerland. AFP

The unprecedented case has exposed a legal vacuum in the country which has long been at the forefront of the global right-to-die debate and an official decision is due in the coming months.

“It is natural that one would rather commit suicide than be buried alive for years to come,” prisoner Peter Vogt said, in a written response to questions submitted by AFP.

The 69-year-old, convicted for sexual assault and rape against multiple girls and women ranging in age from 10 to 56, says he is suffering from serious kidney and heart conditions, among other ailments.

He has also been diagnosed with several psychological disorders. 

Although Vogt's most recent sentence was a 10-year term handed down in 1996, he is imprisoned for life at Bostadel prison in northern Switzerland as he is still considered dangerous.

This follows a decision in 2004 when Swiss voters approved a popular initiative allowing the indefinite detention of people with established sexual delinquencies who posed a public risk. 

The authorities have repeatedly determined that Vogt remains a threat despite years of treatment. 

“It would be better to be dead than to be left to vegetate behind these walls,” he said.

In July 2018, Vogt contacted Exit Switzerland, an organisation that supports assisted suicide under specific conditions. He argues that he should be able to benefit from Switzerland's liberal assisted suicide laws too.

“We told him that his particular case needed to be clarified,” Juerg Wiler, its vice president, told AFP.

'Unbearable suffering'

Swiss law generally allows assisted suicide if the person commits the lethal act themselves — meaning doctors cannot administer deadly injections, for example — and the person consistently and independently articulates a wish to die. 

Organisations that support assisted suicide also apply their own procedures, which are more robust than the legal requirements.  

The authorities, aiming to take a position on the matter in the coming months, have asked the Swiss Centre of Expertise in Prison and Probation, a publicly funded foundation, to provide guidance following Vogt's request.  

In October, the experts at the foundation advised that assisted suicide rights should apply to prisoners under certain conditions, noting that in cases of mental illness two independent specialists should be consulted. 

Any detainee possessing discernment should, in principle, have assisted suicide rights if they have “a physical or mental illness resulting in unbearable suffering,” Barbara Rohner, lead author of the foundation's report, told AFP. 

The foundation also recommended that authorities responsible for the prisoner's welfare must ensure the suicide request is not the result of a short-term emotional crisis.

Vogt insisted that he wanted to die because of the “unbearable” deterioration in his quality of life, along with the fact that he can no longer see his gravely ill mother, who lives in Austria. 

He told the Blick newspaper that he wants to end his life on August 13, his 70th birthday. 

More requests coming?

Rohner said that while Vogt's case may be exceptional, similar situations could increasingly arise. 

“There will be more and more elderly and sick prisoners in detention because of the ageing of the prison population,” she said. 

According to the Swiss National Science Foundation, a research institute, the number of prisoners over 50 years old doubled to 600 between 2005 and 2016. 

Vogt told AFP that he knows of another inmate interested in assisted suicide, adding: “Nobody should have to commit suicide in his cell alone.”

Some have raised concern that assisted suicide requests could be used by convicts as a negotiating tactic to demand better conditions in prison. 

For Christine Bussat, founder of the Swiss chapter of the Marche Blanche victims' rights groups, decisions on a convict's right to die should rest with their victims.

That, she added, “is unfortunately not possible” under the current law. 

But most legal and criminal justice experts in Switzerland believe that assisted suicide rights do extend to convicts. 

Celine Ehrwein, an ethics professor at Heig-VD University, told public broadcaster RTS that depriving a suffering person of the right-to-die could be considered “a form of torture”.

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Switzerland: What is the difference between assisted suicide and euthanasia?

While the terms often are used interchangeably, assisted suicide and euthanasia - and the laws that govern them - are quite different. Here’s what you need to know.

A person in a medical coat holds hands with another
Euthanasia and assisted suicide might be spoken of in the same breath, but they are quite different. Here's what you need to know. Photo by Matheus Ferrero on Unsplash

The terms assisted suicide, assisted dying and euthanasia are often used interchangeably – even by media and politicians covering the matter. 

There are however some key differences, both in terms of the legal situation and the practice itself. 

Assisted suicide is where a medical professional, usually a doctor but sometimes a pharmacist or other specialist, provides some form of medication to assist a patient as they commit suicide. 

EXPLAINED: How foreigners can access assisted suicide in Switzerland

Crucially, it is the patient who takes the final step, i.e. by taking a medication or by pressing a switch through which the medication is administered. 

Euthanasia on the other hand is where the medication which ends someone’s life is administered by a doctor or medical professional. 

Euthanasia is sometimes known as voluntary euthanasia, which references the fact that the patient volunteers for the process by providing consent. 

Other forms of medical intervention which lead to death – for instance turning off life support for someone who has been in a long-term coma – do not fit within the definition of voluntary euthanasia. 

The term ‘assisted dying’ is used as a grouping term to refer to both assisted suicide and euthanasia, although media sources – particularly in the United Kingdom – often use assisted dying when referring primarily to assisted suicide. 

What are the rules for assisted suicide and euthanasia in Switzerland? 

The law in Switzerland recognises the distinction between assisted suicide and euthanasia. 

Euthanasia is not permitted under law in Switzerland, while assisted suicide is allowed for both locals and foreigners. 

While article 115 of the Swiss penal code prohibits assisted suicide for “self-serving reasons” and article 114 prohibits “causing the death” of a person for “commendable motives, and in particular out of compassion for the victim”, assisted suicide for non-selfish reasons is not specifically prohibited as long as certain conditions are met. 

The Swiss supreme court has ruled the following: people must commit suicide by their own hand, for example, by taking medication themselves. A doctor cannot administer a lethal injection without being liable for criminal prosecution.

People must also be aware of actions they are undertaking and have given due consideration to their situation. In addition, they be consistently sure they wish to die, and, of course, not be under the influence of another person, or group of persons.

READ MORE: What you need to know about assisted suicide in Switzerland

Several other jurisdictions across Europe and the globe also make a legal distinction between the two, although euthanasia is legal in some countries including the Netherlands, Belgium, Luxembourg and Columbia. 

What is the medical procedure involved?

Most Swiss associations request that patients drink sodium pentobarbital, a sedative that in strong enough doses causes the heart muscle to stop beating.

Since the substance is alkaline, it burns a bit when swallowed.

A professional prepares the needle, but it is up to the patient to open the valve that allows the short-acting barbiturate to mix with a saline solution and begin flowing into their vein.

A video is shot of the patient stating their name, date of birth and that they understand what they are about to do. The camera keeps rolling as they open the valve and the footage is used as evidence that they willingly took their own life.

It usually takes about 20 to 30 seconds for the patient to fall asleep.