Euthanasia in Switzerland: laws, procedures and ethical debates

The legal framework for assisted suicide in Switzerland

Switzerland occupies a unique position in Europe concerning euthanasia and assisted suicide. Since 1942, Article 115 of the Swiss Criminal Code has tolerated assisted suicide under certain strict conditions.

It is essential to understand the fundamental distinction: active euthanasia remains prohibited in Switzerland. A doctor cannot administer a lethal substance to a patient themselves. On the other hand, assisted suicide is tolerated: a person can obtain the means to end their life, provided they perform the final act themselves.

The legal conditions are clear: assistance is only authorised in the absence of selfish motives on the part of the person providing help. The individual must possess full capacity of discernment at the time of the act.

Each canton may apply specific rules concerning the places where assistance can be practised (home, care homes, hospitals). To anticipate your end-of-life wishes, consult our guide on living wills and advance directives.

Conditions and eligibility criteria

Access to assisted suicide in Switzerland requires compliance with strict conditions that protect vulnerable people.

Capacity of discernment: The person must be able to understand the nature and consequences of their decision. A medical and sometimes psychiatric evaluation is systematically carried out.

Free and considered will: The request must be voluntary, persistent and made without external pressure from family or those around them.

Medical situations: Traditionally, assistance concerns people suffering from incurable illnesses or unbearable pain. The case of mental illnesses is currently the subject of intense ethical debates.

Residence and death tourism: Swiss residents and foreigners can access the services, although some organisations limit their support to residents. Approximately 1,300 people receive assisted suicide in Switzerland each year, of whom around 200 come from abroad.

Assisted suicide organisations

Several Swiss associations offer support for assisted suicide. The main ones are Exit, Dignitas and Lifecircle.

These organisations operate according to similar principles but with different membership criteria. Exit, the oldest, is reserved for Swiss residents. Dignitas accepts members from around the world.

The typical process includes several stages:

• Membership of the association and compilation of a complete medical file

• Medical consultation to assess the situation and capacity of discernment

• Mandatory reflection period (generally several weeks)

• Final support in an appropriate location

Costs vary between 4,000 and 10,000 CHF depending on the organisation and situation. Doctors play a central role: they prescribe the lethal substance (generally pentobarbital) after verifying all legal conditions.

Exit and Dignitas: two different models

Exit was founded in 1982 and has more than 130,000 members. The association is strictly reserved for Swiss residents and favours a local approach. Exit supports around 800 people per year and actively campaigns for the right to self-determination.

Dignitas, created in 1998, is distinguished by its international openness. The organisation supports approximately 200 to 300 people annually, the majority of whom are foreigners (mainly Germans, British and French). This specificity has earned Switzerland the controversial term "death tourism" destination.

The profiles differ slightly: Exit mainly supports elderly people with degenerative diseases, whilst Dignitas receives more requests related to neurological or psychiatric illnesses. Both organisations firmly defend individual autonomy in the face of end-of-life questions.

International comparison: where do other countries stand?

Switzerland remains an exception in Europe, but other countries have also legalised certain forms of assisted dying.

The Netherlands, Belgium and Luxembourg have authorised active euthanasia since the 2000s. A doctor can directly administer a lethal substance to a patient who requests it under strict conditions.

Canada legalised medical assistance in dying in 2016, with a progressive extension of eligibility criteria.

Certain American states (Oregon, Washington, California) authorise medically assisted suicide.

On the other hand, France, Germany and Italy maintain the prohibition, although recurring parliamentary debates agitate these countries. France has recently opened a national reflection on end of life.

This situation explains why Switzerland attracts people from neighbouring countries seeking a way out of their suffering. To understand the implications of a death occurring outside the country of origin, consult our article on procedures in the event of a death abroad.

Ethical and philosophical debates

Assisted suicide raises fundamental ethical questions that divide Swiss and international society.

The principle of autonomy constitutes the central argument of supporters: each individual should be able to freely decide the moment and conditions of their death, particularly when facing unbearable suffering.

Human dignity is subject to opposing interpretations. For some, dying with dignity means being able to choose one's end. For others, dignity is inherent to human life, regardless of health status.

The role of the doctor is questioned: is their mission exclusively to treat and prolong life, or does it include support towards a chosen death?

The risks of abuse concern opponents: social pressure on elderly people, vulnerability of disabled people, progressive normalisation of assisted death. The "slippery slope" theory suggests that relaxing criteria would lead to abuse. Swiss data do not confirm this fear for the time being.

Arguments in favour of the right to die

Supporters of the right to die put forward several fundamental arguments.

Autonomy and individual freedom: In a democratic society, everyone should have control over their body and their life. This fundamental freedom includes the choice of the moment of one's death.

Relief from suffering: Faced with unbearable physical or psychological pain, assisted suicide offers a respectful way out. Some medical situations leave no hope of improvement.

Quality versus quantity: Artificially prolonging a life marked by suffering does not always respect the person's dignity. The quality of the final moments matters more than their duration.

Testimonies from people who have chosen this path and their families often emphasise the relief of having been able to leave "in time", surrounded by loved ones, rather than undergoing progressive deterioration.

Arguments against assisted suicide

Opponents of assisted suicide defend equally fundamental principles.

Sanctity of life: Human life has an intrinsic value that does not depend on health status. No suffering justifies ending it voluntarily.

Role of the doctor: The medical profession is based on the Hippocratic oath: to heal, not to harm. Participating in a patient's death, even at their request, contradicts this fundamental mission.

Protection of the vulnerable: Elderly, disabled or dependent people might feel obliged to "free" their family from a burden. This social pressure, even implicit, represents a real danger.

Religious concerns: Many spiritual traditions consider life as a sacred gift whose end only God can decide.

Alternative of palliative care: Quality end-of-life care can effectively relieve most suffering, making assisted suicide unnecessary.

Positions of health and society actors

The different actors in Swiss society adopt nuanced positions on assisted suicide.

The Swiss Academy of Medical Sciences (SAMS) has published guidelines framing the practice. It recognises assisted suicide as a legitimate option in certain situations, whilst insisting on the protection of vulnerable people and respect for doctors' conscience.

Churches generally maintain firm opposition, although some nuanced voices are emerging. The Catholic Church clearly condemns assisted suicide, whilst some Protestant communities adopt a more open position to debate.

Patient associations and rights advocacy groups mainly support the right to self-determination, particularly in cases of neurodegenerative diseases.

Swiss public opinion broadly supports the status quo: approximately 80% of Swiss people approve of current legislation according to recent polls. This social acceptance distinguishes Switzerland from many neighbouring countries.

Palliative care and alternatives to assisted suicide

Palliative care constitutes an essential alternative to assisted suicide for many people at the end of life.

Pain management: Medical advances now make it possible to effectively relieve most physical pain. Analgesic treatments, adapted and adjusted, offer significant comfort.

Psychological support: Emotional and spiritual support helps patients and their families go through this difficult period with dignity.

Availability in Switzerland: Although palliative care is developing, access remains unequal depending on the canton. Approximately 60% of people who would need it actually access it.

Deep palliative sedation: This practice consists of putting the patient into a deep sleep until their natural death, thus relieving unbearable suffering without directly causing death.

Palliative care and assisted suicide do not necessarily oppose each other: they can be complementary, offering different responses to diverse situations.

Preparing your end-of-life wishes

Anticipating your end-of-life wishes constitutes an act of responsibility towards yourself and your loved ones.

Advance directives allow you to express your wishes concerning medical treatments, resuscitation, palliative care and assisted suicide. These legal documents guide doctors and relieve your family of difficult decisions. Consult our complete guide on living wills and advance directives to understand how to draft them.

Dialogue with your loved ones remains essential. Addressing these questions whilst alive, even if it is uncomfortable, avoids conflicts and uncertainties at the crucial moment.

The mandate in case of incapacity designates a trusted person to make decisions on your behalf if you are no longer able to do so.

Wolky supports you in planning your wishes and facilitates their communication to your loved ones. Publish an obituary to honour the memory of a departed loved one.

Switzerland occupies a unique position in the world regarding assisted suicide. Its liberal legal framework, governed by Article 115 of the Criminal Code, allows people with capacity of discernment to choose the moment of their departure. Exit, Dignitas and other organisations offer respectful support, in compliance with strict criteria.

This model raises profound ethical debates: between the right to self-determination and protection of vulnerable people, between dignity of death and value of life. Palliative care represents an essential alternative, offering comfort and support until the end.

Whatever your position on these questions, preparing your end-of-life wishes remains an act of responsibility and kindness towards your loved ones. Advance directives allow you to clearly express your medical wishes and relieve your family of difficult decisions. And when the time comes to honour the memory of a loved one, Wolky supports you in publishing a dignified and accessible obituary.