The only catch: Those patients had to get to Switzerland, which has virtually no definitive regulations on assisted suicide (AS). It is unique in the world in that way; all other countries have bans or clear restrictions.
This legislative particularity has enabled a phenomenon known as "suicide tourism," the startling growth of which is the subject of a new study in the Journal of Medicine and Ethics.
Researchers at Zurich's Institute of Legal Medicine found that between 2008 and 2012, 611 people from outside Switzerland had been helped to die there. All but four went to Dignitas. Those numbers reflect a sharp, then steady rise in the number of AS cases, which doubled between 2009 and 2012.
“I have always been convinced that the right to die is, in fact, the very last human right,” Ludwig Minelli, founder of Dignitas, told Bruce Falconer of The Atlantic in 2010. “Why should I be able to tell a Swiss lady suffering from breast cancer with metastases that Dignitas will help her, but tell a French lady with the same condition just on the other side of the border that we will not?”
Bordering countries, however, aren't the only places Switzerland's influx of AS-seekers are coming from. According to the study, residents from 31 countries, with a range of underlying diseases, sought AS in Switzerland. Most of these cases were from Germany (268) and the U.K. (126). Other top origins included France, Italy, the U.S., Austria, Canada, Spain, and Israel.
The researchers hypothesize that some of these countries have actually amended their own AS legislation in response to suicide tourism's rise. "Looking at the legislation in the top three countries," they write, "political debate is to be found in all three."
That's in part reference to a 2012 draft law in Germany that would make commercial assisted suicide punishable, and a 2010 clarification about the extent of punishment for assisting suicide in the U.K. There, the researchers write, "'going to Switzerland' has become a euphemism for AS."
For their part, Swiss legislators and voters have routinely rejected propositions that would limit the country's liberal AS policy and crack down on suicide tourism. Which is a little curious, since many Swiss are suspect of Dignitas' profit margins and its founder's zeal for death. In 2008, Minelli, who is in his eighties, filmed a "demonstration" of assisted suicides that used helium gas, rather than the standard lethal narcotic, on the patients. The video was met with outrage and disgust. Falconer writes of how a Swiss doctor and a Swiss lawyer described Dignitas' future prospects:
“If Dignitas is not careful and tries to do crazy things, it might happen that foreigners can no longer come to Switzerland, which I think would be too bad,” the doctor said. “Minelli is narrow-minded. It’s very difficult to talk to him about what is reasonable and what is not … He is fighting against everything and everybody.” She seemed unsure that Dignitas will survive him. “I can’t imagine that he will give it over to anybody, unless he becomes ill or gets too old,” she said. “But I hope he stops working soon.”
So does Brunner, the public prosecutor. Several years ago, citing Minelli’s age, he joked to friends that his problem with Dignitas would ultimately be solved biologically.
If Dignitas shut its doors, there would be, as of now, no clear replacement; no other AS organization is currently willing to serve such an international clientele. And that, for certain people already suffering, would be another painful blow.