'Suicide Tourism' to Switzerland Doubled Within Four Years

The number of people who sought out assisted suicide in Switzerland doubled between 2008 and 2012, according to a study released in The British Medical Journal. The country's uniquely liberal stance on rights-to-die has made it the world capital of "suicide tourism."

Almost half of the people who make this fatal pilgrimage suffer from advanced neurological diseases, such as paralysis, Parkinson's disease, multiple sclerosis, or other chronic conditions like cancer and rheumatic disease.

Interestingly, the majority (58.5 percent) were women, who were 40 percent more likely to choose assisted suicide than men. This is somewhat surprising since men are three times more likely to commit suicide than women in unassisted or spontaneous situations.

The diversity of nationalities drawn to Switzerland for this reason was also interesting. A total of 611 people from 31 countries arranged to die within the four-year span cited by the BMJ. 268 were Germans, 126 were from the UK, 66 were French, 44 were Italian, 21 were American, and 12 were Canadian. All but four of the 611 patients chose to die with Dignitas, Switzerland's most established assisted dying group, which is based near Zurich.

One of those 607 Dignitas patients conducted a particularly interesting AMA on Reddit on August 27, 2012, which provided a more personal window into the procedure.

"I am twenty-three years of age, and tomorrow I will be flying out to Switzerland to start the four month process of being assisted in suicide," said user 'digitaspatient,' whose identity was verified by the Reddit administrators.

"I have terminal lung, and bronchial cancer, and my quality of life, and the amount of medication I need to take to live some form of normality is no longer worth it to me," said the patient. "I want it to be as painless, and quick as possible I do not want to risk their [sic] being complications, and the end result suffering even more if something does not go right. I also want my family to be with me, and I could not put them through some botched suicide attempt."

The youngest suicide reported in the BMJ study was also a 23-year-old, but the patient's anonymity makes it difficult to confirm that it was the same person who conducted the AMA. But it bears mentioning that the median age was much higher, at 69, and the oldest person to be assisted was 97.

Sodium pentobarbital was by far the most common drug administered in the clinics (though a few patients inhaled helium). It's the same drug used to euthanize most pets, and causes rapid and humane respiratory arrest. According to the 2012 AMA, the entire procedure costs about $11,000.

The spike in suicide tourism in Switzerland may well influence other countries to pursue similar policies. Similar procedures are currently legal in a weird mashup of countries—Germany, Albania, Colombia, and Japan—though none of the programs are anywhere near as comprehensive as those in Switzerland. Assisted suicide is also legal in five US states: Washington, Oregon, Vermont, New Mexico, and Montana.

Euthanasia, meanwhile, is legal only in the Netherlands, Belgium, and Luxembourg. The difference between the two procedures is that assisted suicide requires the patient to control the actual act of suicide, with help from professionals. Euthanasia is controlled by a health care provider, not the patient, so is more common in cases where the patient is mentally incapacitated or comatose.

Switzerland's rise in suicide tourism clearly displays a demand for controlled, humane dying, completed on the terms of the person who has to actually experience it. It's hard to argue with the perspective of those for whom this is the best option, like the patient behind the AMA.

"I am calm because I now know when I am going to die, and not wondering day in, and day out what will happen to me," the patient said. "I imagine [my death] will be full of tears, and joy at the same time. It will be extremely emotional for both me, and my mother. I will finally be at peace."