The act of seeking death in another country by the help of physician or non physician helper is termed as suicide tourism in today’s world. However, this is stated to be different from mercy death called Euthanasia. Euthanasia is till not acceptable as yet but the assisted death is termed legal in Switzerland, The Netherlands, Belgium, and Oregon State of USA. Its perhaps an act of buying death in legal terms where the existing law of the land permits to do so. The Swiss law that allows anyone to help patients die, as long as there are no ulterior motives, dates back to 1942.
Article 115 of the Swiss penal code considers assisting suicide a crime if and only if the motive is selfish. It condones assisting suicide for altruistic reasons. In most cases the permissibility of altruistic assisted suicide cannot be overridden by a duty to save life. Article 115 does not require the involvement of a physician nor that the patient be terminally ill. It only requires that the motive be unselfish. This reliance on a base motive rather than on the intent to kill to define a crime is foreign to Anglo-Saxon jurisprudence, but it can be pivotal in continental Europe.
Swiss law does not consider suicide a crime or assisting suicide as complicity in a crime. It views suicide as possibly rational. In 1918, a comment by the Swiss federal government on the first federal penal code stated: "In modern penal law, suicide is not a crime . . . Aiding and abetting suicide can themselves be inspired by altruistic motives. This is why the project incriminates them only if the author has been moved by selfish reasons." At the time, the attitudes of the Swiss public were shaped by suicides motivated by honour and romance, which were considered to be valid motives. Motives related to health were not an important concern, and the involvement of a physician was not needed. Euthanasia for terminally ill patients, although intensely discussed in the United States and the United Kingdom in the 1900s, seems not to have been debated in 1918 in Switzerland.
Swiss law does not recognise the concept of euthanasia. "Murder upon request by the victim" (article 114 of the Swiss penal code) is considered less severely than murder without the victim's request, but it remains illegal. Following a proposal to the Swiss parliament to decriminalise euthanasia, in 1997 the federal government commissioned a working group which included specialists in law, medicine, and ethics to examine the issue. This group recommended that euthanasia remain illegal. Despite this report, parliament voted not to go ahead with the proposed legislation, and a change is unlikely in the near future. The Swiss National Advisory Commission on Biomedical Ethics is debating these issues. Its position cannot be predicted.
Assisted suicide is a controversial topic in Switzerland, but data on public attitudes towards assisted suicide and euthanasia are scarce. According to one survey, half of 2411 army conscripts were willing to "shorten the life of a family member who suffered too much and who asked for euthanasia." In a 1999 survey of the Swiss public, 82% of 1000 respondents agreed that "a person suffering from an incurable disease and who is in intolerable physical and psychological suffering has the right to ask for death and to obtain help for this purpose." Of these, 68% considered that physicians should provide this help; 37% considered that the family, 22% that right to die societies, 9% that nurses, and 7% that religious representatives should be able to fulfil such requests. Legislation to allow euthanasia was favoured by 71% of all respondents. No data are available on how well people believe the existing system is working in practice, even though this is one of the key points in the controversy.
No validated statistics exist for assisted suicides in Switzerland. These deaths are not differentiated from unassisted suicides in official records. According to the president of one of the Swiss right to die societies, around 1800 requests for assisted suicides are made each year. Two thirds are rejected after screening. Half of the remaining people die of other causes, leaving about 300 suicides assisted by these societies annually. This constitutes around 0.45% of deaths in Switzerland (J Sobel, personal communication, 2002). Individuals outside these societies may assist additional suicides. In comparison, reported assisted suicide in Oregon represents 0.09% of deaths, and other US data showed a rate of assisted suicide and euthanasia of 0.4% among terminally ill patients. The rate of assisted suicide in the Netherlands is 0.3%, lower than the estimate for Switzerland.
Nevertheless Suicide tourism is making headlines in Switzerland whether it is for wrong reason or right reason. A 2003 study published in the Lancet showed 0.36 per cent of deaths in German-speaking Switzerland were assisted suicides, compared with 0.21 per cent in the Netherlands and 0.01 per cent in Belgium. Since then, the rate in German-speaking Switzerland has risen to 0.5 per cent. The assisted suicide rate in Oregon was 0.12 per cent last year, according to the state's Department of Human Services.
Dignitas split from Exit Deutsche Schweiz, the biggest right-to-die association in Switzerland, in 1998 and had more than 4000 members at the end of 2004, according to its website. Exit, founded in 1982, has about 50,000 members. It doesn't take clients from abroad because the distance makes it difficult to assess their judgment and motivation.
Dignitas uses letters and phone conversations to establish a relationship with foreign clients. It is much more difficult to establish that a patient has a consistent wish to die and is under no external pressure if the patient is far away, in a different legal, cultural and health-care environment, and possibly speaking a different language.
Dignitas helps patients to obtain a prescription for a lethal dose of the barbiturate natrium-pentobarbital, but the patient must ingest it himself, said founder and Chief Executive Ludwig Minelli on the group's website. Natrium-pentobarbital isn't available in Germany.
Death Dignitas members pay 100 Swiss francs ($80) to join and an annual fee of 50 francs. Germans are required to join Dignitate-Deutschland, a group headed by Minelli that is lobbying for the right to assist suicides in Germany, for €95 ($190) plus €16 a month. Dignitas charges 2000 francs to help with a suicide.
With comments received from legal, medial and other civil society group, The Swiss government decided to look into the law freshly but the Swiss Cabinet sees no need to tighten restrictions on assisted suicide, despite the fact that the country has become a favourite destination for "death tourism", and that Switzerland's leading euthanasia doctor has pledged to open a chain of for-profit killing facilities.
Therefore, the debate around the world still continues whether this suicide tourism is right or wrong, the intended people keep coming to these destinations for assisted suicide. But in human life, suicide is a most difficult act and should not be justified as joyful event. People world over should stand against it and oppose strong to ban it wherever it is taking place. Let us make the world full of living tourism and not of death.
