is one of the advantages of a country where the debate on ending life has fewer taboos: Switzerland does remains a very long time without ever wonder about the implications of the chosen death. And issues that periodically returns on the mat is one of the reasons the choice to die. Should it be the end of life? Should we even suffer from a disease? Is it enough to simply ask to die, whatever our reason for death by drugs? Is it enough to be 'tired of living'? In Switzerland assisted suicide is legal (Art. 115 Swiss Penal Code) provided that three conditions are met. person who wants to die to make itself the fatal act, and must be capable of discernment. The person who agrees to attend should not have selfish motives. And that's all. Very few requirements, so.
In practice, however, more criteria are applied. It is therefore disturbing story on this Dignitas released last week. It is filmed suicide Michèle Causse, a French eloquent, intelligent, lively, not dying, and who declares that his life is losing its shape '. The doctor who gave him the green light, and reflecting in anonymity on the assumption that patient choice will prevail. Is it enough? Another case raised questions at this time but close (ie important) a little different. André Rieder, a Swiss patient suffering from manic-depressive, and who has resorted to the EXIT for assisted suicide . Should we have access to assisted suicide while a patient suffers from a psychiatric illness?
These two types of cases, motivated by a 'tired of living' or a mental illness are very different. Among the requests for assisted suicide, they are among the most difficult cases. To clarify the issues raised here, three scores are required.
First, acceptance of assisted suicide is legal where it is generally on co-existence of two dimensions: an authentic choice, but also the presence of incurable suffering. Something that resembles a disease is indeed required, at least by the opinion . In Switzerland, it is not required by law but guidelines of the Swiss Academy of Medical Sciences , linking physicians and other caregivers state that the person must be sick and dying. And most aid organizations also require the suicide.
Second, even if it requires both a free and unbearable suffering, we must still define these terms. And it turns out that both can confusing. One can for example think that a person suffering from mental illness can not make a free choice. His desire to die will result pathological of his illness. This is often true. But not always. The National Commission on Ethics has seen it. In a position on assisted suicide, it stated two things complementary :
'suicide attempters suffer from mental illness, combined or not with somatic diseases, need first of psychiatric treatment and psychotherapy. If the desire for suicide is an expression or a symptom of mental illness, there can be no question of assisted suicide. "
(...)
'For an exception to this rule, it is necessary but not sufficient, as the emergence of desire suicide neither derives from an expression or symptom of a mental illness, but occurs, for example, during an interval free of symptoms of a chronic development so far. "
The key point is that there are cases where a person with mental illness will meet the same criteria a person suffering from another disease. Severe suffering, and free choice that is not an expression of mental illness. These cases are difficult to identify. But this does not mean it's always' disease who spoke when someone with a mental illness and discerning wants to die. And when the choice meets the same criteria as that of another person, do not treat them the same way is discriminatory. A Federal Court's decision in this direction was recently .
The third point is the controversy surrounding assisted suicide in cases of chronic pain, when the person is not terminally ill. This is often referred to 'Fatigue life', and it is understandable that assisted suicide in such cases gives rise to controversy. Especially since often seems Dignitas 'play limits', for example around situations assisted suicide couples which only one person is sick . Despite the visibility of such cases, it should however be remembered that most assisted suicide beyond the end of life involve people indeed sick, except that their disease, chronic and incurable indeed, does not life threatening right now. Rather than 'fatigue life', we should rather speak of 'fatigue suffer' ... Both types of cases raise one and the other difficult issues. But they are different
A minefield, so. Handle with extreme caution.
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