After several months of consultation, the Swiss Academy of Medical Sciences (SAMS) has just published new directives on end-of-life care, which are intended to make the 2004 guidelines more flexible. The Swiss Senate overwhelmingly approved them, voting 41 in favour and one against, with two abstentions.
Until now, physicians could only prescribe lethal drugs to terminally ill patients nearing the end of their life. The criterion of “end of life” has been replaced by that of “unbearable suffering due to symptoms of illness and/or functional limitations”.
The decision has been strongly criticised by the Fédération des Médecins Suisses (Swiss Medial Association, or FMH), which has over 40,000 members, making it the country’s largest medical association. It has its own ethical criteria relating to assisted suicide, which are more restrictive than SAMS criteria.
FMH President Jürg Schlup explained, “The notion is vague, and that could pose problems of interpretation before the ethics commission. This is particularly problematic for such a major decision because there is no turning back”. He said that FMH will be meeting to work together and that he is unsure if the new guideline will be incorporated into its code of ethics. “Nothing has been decided yet. We will carefully examine the issue before taking a stance. That will take several months”.
Samia Hurst, a member of the subcommittee that drafted the end-of-life directives, acknowledged that the notion of unbearable suffering is subjective. “It rests upon the physician’s assessment. Based on the patient’s history and after repeated medial interviews, the physician must be convinced that suffering is unbearable. Whatever the conclusion, the physician retains the right to refuse to assist the suicide in any event. He or she still has the freedom to do that. No one can be forced against their will”.
For further reading:
2017 assisted suicide rate up by 32.5% in French-speaking Switzerland
Assisted suicide is rising sharply in Switzerland
End of life in Switzerland: an alarming finding
Switzerland: new guidelines for assisted suicide and sedation
24 heures, Gabriel Sassoon et Caroline Zuerch (06/06/2018) ; Le Temps, Céline Zund, (06/06/2018)