Suicide or suicide What does this mean and what are the options?
Self-determination meets a need in our society. In the event of serious illness, at the end of life, we want to make our own decisions and have a say in the treatment and care we receive.
Better to die than ... Anyone who is afraid of the possible pain of dying, who is fed up with life, who is ill, frail, sad and desperate, thinks about death. That is our right. Self-determination in the last phase of life is the law. We will show you where you can find help and who has wise information for you.
Ways of self-determination
The following applies before someone wishes to leave life voluntarily: Seek a conversation. Talk to someone about your wish to die. For example, with professionals at the emergency telephone service "Die Dargebotene Hand". Help is anonymous there and the advice is competent.
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Your self-determination in the last phase of life
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Your last wishes are taken into account in medical measures
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Quick & easy to create online
Legal
Euthanasia
- Passive euthanasia: The renunciation or discontinuation of life-sustaining measures (e.g. oxygen device is switched off, chemotherapy treatment is discontinued). This form of euthanasia is not expressly regulated by law, but is considered permissible and is generally accepted in Switzerland.
- Assisted suicide (also known as assisted suicide): The patient is given the lethal substance, which they then ingest themselves without outside intervention. Organizations such as EXIT provide assisted suicide within the framework of this law. Only those who help someone to commit suicide "for selfish reasons" (e.g. by procuring a lethal substance) are liable to prosecution.
- Physical and psychosocial support: This also includes palliative medical care measures, which include medical treatment, physical care, but also psychological, social and pastoral support for the patient and their relatives. They can significantly improve the quality of life of the seriously ill and dying.
Active euthanasia can be carried out directly or indirectly.
- Direct active euthanasia: Deliberate killing to shorten the suffering of another person. The doctor or a third party deliberately gives the patient an injection that leads directly to death. If this is done at the request of the seriously ill or dying person, it is called killing on demand. Direct active euthanasia is now punishable under the Swiss Criminal Code.
- Indirect active euthanasia: drugs (e.g. morphine) are used to alleviate suffering, which can have the side effect of reducing life expectancy. The possibility of an earlier death is accepted. This type of euthanasia is not expressly regulated in the German Criminal Code, but is generally permitted.
Legality
Legally permissible
- Suicide: A person helps himself to die. Interpreted by some as an expression of personal freedom. A suicide attempt often takes place in an exceptional mental state and with impaired judgment, which is why suicide prevention is so important.
- Assisted suicide: Legally permissible if it is not carried out for "selfish reasons".
Legally punishable
- Direct active euthanasia: The active killing of another person is expressly prohibited in Switzerland and therefore also direct active euthanasia. This involves the targeted killing of another person at their express request with the motive of killing the seriously ill or dying person, rather than curing them or alleviating their pain.
- The deliberate and direct killing of a patient in the dying phase can be classified as intentional homicide, manslaughter (includes cases in which the act is carried out under great excusable emotion or under great emotional stress) or homicide on demand (includes cases in which the act is carried out out of compassionate motives).
Palliative care
Palliative care is the comprehensive treatment and care of people with incurable, life-threatening or chronically progressive illnesses. Its aim is to enable patients to enjoy the best possible quality of life. This includes supporting the patient's relatives. Palliative care aims to alleviate the suffering of the patient in the best possible way and, in accordance with the patient's wishes, also take into account social, emotional-spiritual and religious-spiritual aspects. High-quality palliative care relies on professional knowledge and working methods. As far as possible, it takes place in the place that the patient wishes. Its focus is on the time when dying and death become foreseeable, but it often makes sense to use palliative care proactively and at an early stage, possibly in parallel with curative measures.
Palliative care at home?
What conditions need to be met so that someone does not have to spend their last days in hospital? More and more often, most people's wish to spend their last days at home can be fulfilled. An emergency and action plan is used to try to plan ahead as far as possible. It sets out who can do what for which symptoms. Care instructions are often written down by a specialized Spitex. In addition, the wishes of relatives and those affected as well as all contact telephone numbers are recorded. Palliative care always means being able to count on a broad support network. This includes the family doctor, Spitex and specialized services. If someone no longer wants to go to hospital, the number 144 should not be on the list.
Legal & Financing
Regardless of age, illness, origin or financial means, seriously ill and dying people in Switzerland receive palliative care adapted to their situation. Palliative care is financed in accordance with the general principles of the KVG. Patients who are capable of judgment have the right to make their own decisions about medical and nursing treatment and care. The Federal Constitution grants people a fundamental right to physical and psychological integrity. As a medical intervention constitutes bodily harm, the patient must give their consent and can also refuse a planned intervention (Naef, Hölzle-Baumann & Ritzenthaler-Spielmann, 2012).
Dying and death = ethics
Palliative care is intended to reduce physical complaints, but also to address psychological, social and spiritual problems. The main aim is to improve the quality of life for those affected and their relatives. If necessary, relatives are also supported beyond the dying phase.
Further information on the subject of palliative care can be found at:
Suicide
Non-assisted suicide is the deliberate ending of one's own life by brutal methods (firearms, hanging or poisoning). People often choose this path out of deep despair, depression or addiction.
It's all about the way. Why does a train driver have to suffer? Or a policewoman? Why the people from the care team? Why the family members? Why the people who clean up the accident sites? Why do desperate people who are tired of life drag others down with them? Is there no decent, gentle way to end life when someone no longer likes it? When someone is fed up with life?
If you are having suicidal thoughts, talk to someone - take advantage of the many counseling services available.
Further information and support:
Organized euthanasia
Switzerland has some of the most liberal legislation on euthanasia in Europe. The most common reasons why people make use of organized euthanasia, which is legal in Switzerland, are cancer, a neurodegenerative disease or cardiovascular disease. Euthanasia in the case of dementia is therefore a very critical issue, as the person concerned no longer has the capacity to make the delicate decision in the case of advanced dementia. Assisted suicide must therefore be carried out while the person still has the capacity for judgment. In contrast to non-assisted suicide, the organizations mentioned here take a close look at the situation of the person concerned. Discussions and counseling are used to counteract a short-sighted act.
EXIT
The conditions for assisted suicide, which are not prescribed by law but which EXIT itself has included in its statutes, are: hopeless prognosis or unbearable discomfort or unreasonable disability. For EXIT, it is crucial that the person concerned decides for themselves what is unbearable or unreasonable for them. It is important and required by law that the person who wishes to die is capable of judgment. EXIT therefore requires a doctor to confirm the person's capacity in writing. The wish to die must also have come about autonomously, i.e. uninfluenced by a third party. The conditions of balance and consistency are also intended to ensure that the wish to die has been thoroughly thought through and is not the result of a momentary depressive mood or crisis. Assisted suicide is about taking responsibility for deciding when and how to die.
Further information:
- www.exit.ch
- Assisted suicide: "EXIT also prevents suicide"
- "For my mommy, death was a release"
- Better to die than suffer dementia: controversial suicide with Exit
Dignitas
Living with dignity - dying with dignity, the motto of Dignitas. Dignitas provides support in all matters relating to the end of life, questions on the legal development of the last things, cooperation with doctors, clinics and other organizations, enforcement of patients' rights, prevention, support in conflicts with authorities and doctors, end-of-life care and assisted suicide. At Dignitas, too, the criteria for support are an illness leading to death and/or an unacceptable disability and/or uncontrollable pain. Dignitas is based in Zurich and has a section (association) in Germany, specifically for people resident in Germany.
Further information:
Doctor
The law allows any doctor to help a patient who is capable of judgment to achieve a "clean" suicide. In principle, they may issue a prescription for sodium pentobarbital. However, a doctor's fundamental aim is to save or cure lives. He will be wary of issuing such a prescription without a similar examination to that carried out by euthanasia organizations.
Further information:
Death fasting
Fasting to die involves deliberately abstaining from eating. It is a process that the dying person can stop after three to seven days without suffering any harm. It necessarily requires well-discussed and sometimes intensive care. Family and friends are usually intensively confronted with the dying process for 8 to 14 days. Depending on the condition of the dying person, medical care is necessary and palliative care is essential. They may have a living will in which they write that they no longer want food or an infusion if they refuse to eat. The distinction between "euthanasia fasting" for terminal illnesses versus euthanasia fasting for non-dying patients seems very important. In terminal illnesses, including severe end-stage dementia, abstaining from food and fluids or the lack of hunger and thirst is physiological because it is ultimately part of the dying process. The situation is different for people who are not dying and especially for young people. In this group, the feeling of thirst is fully present and it takes a strong will to resist it. This fact is a great source of suffering. It puts a strain on relatives and carers. A less serious problem is the feeling of hunger. Experience has shown that it is much easier to go without food. People who choose this path must be aware that fasting to die is a process that takes more than just three to four days. For younger people in particular, it is a very difficult way to die. If someone decides to fast to die, the following conditions must be observed: It is not possible to predict which path one's personal dying will take. In any case, it is important to be aware of the options. Options that are considered appropriate for the person concerned. These options can be discussed with the relevant people, such as the family doctor.
Legal situation
Consciously and voluntarily abstaining from food and liquids is actually legally unproblematic. It is permitted to shorten the personal dying process in this way. Depending on the specific circumstances of the death, the police or the public prosecutor's office will initially assume an "extraordinary death" and carry out an investigation. This is because it is conceivable that the deceased did not voluntarily abstain from food and liquids, but was urged to do so by relatives (so-called inducement to suicide, Art. 115 StGB). And that the relative would have been obliged to call in help due to the circumstances. Namely, if the person concerned had no intention of dying, but was prevented from eating and drinking due to illness. Of course, such cases are rare, but because they do occur, the police may have to investigate the cause of death in more detail.
Ethics
Actually, the decision as to whether or not I feel my life is worth living cannot be delegated to others. As long as someone is capable of judgment, they always decide for themselves. Nevertheless, in certain medical situations, there is no alternative to deciding on one's own behalf whether life-sustaining measures should be used or discontinued. These decisions are made on a proxy basis in accordance with the decision-making cascade in child and adult protection law.
You can find further information on the subject of fasting to die at: