Suicide tourism a grisly problem for the Swiss

Gloria Sonny says she barely noticed her Zurich apartment building was a place where people went to die when she moved there six years ago. Now, she can't miss the body bags placed in the lift by Dignitas, the assisted-suicide organisation on the fourth floor.

Dignitas helped 138 people to kill themselves last year, a third more than in 2004, according to its website. Almost 90 per cent came from outside Switzerland, mostly Germany. "The suicides happen almost daily, Tuesday to Friday," said 54-year-old Sonny at her home in Wiedikon, a working-class district of Zurich. "Friday is a rush day. It's horror."

Swiss lawmakers are responding by proposing to increase supervision of groups that help people to commit suicide. The rate of assisted suicides in the German-speaking part of Switzerland is the highest of the four places worldwide that allow it, according to a 2003 study.

"Suicide tourism is making headlines," said Christian Weber, a spokesman for the Radical Free Democratic Party, one of the four governing parties. "Some say foreigners can come, others say no. We want clear conditions."

His party plans to ask parliament for a commission to tighten oversight of assisted-suicide groups.

Martin Schwyn, who has a seat in Zurich's city parliament, is asking the local government to stop Dignitas from operating in Sonny's building.

The Swiss law that allows anyone to help patients die, as long as there are no ulterior motives, dates back to 1942. The only other places that permit suicide assistance are Belgium, the Netherlands and Oregon. All three require a close relationship between doctor and patient, or limit the action to residents.

"Alpinist guides need a licence and are strictly controlled, but assisted suicide isn't," said Georg Bosshard, a physician and researcher at the University of Zurich.

A 2003 study published in the Lancet showed 0.36 per cent of deaths in German-speaking Switzerland were assisted suicides, compared with 0.21 per cent in the Netherlands and 0.01 per cent in Belgium.

Since then, the rate in German-speaking Switzerland has risen to 0.5 per cent. The assisted suicide rate in Oregon was 0.12 per cent last year, according to the state's Department of Human Services.

Dignitas split from Exit Deutsche Schweiz, the biggest right-to-die association in Switzerland, in 1998 and had more than 4000 members at the end of 2004, according to its website. Exit, founded in 1982, has about 50,000 members. It doesn't take clients from abroad because the distance makes it difficult to assess their judgment and motivation, spokesman Andreas Blum said.

Dignitas uses letters and phone conversations to establish a relationship with foreign clients. "It is much more difficult to establish that a patient has a consistent wish to die and is under no external pressure if the patient is far away, in a different legal, cultural and health-care environment, and possibly speaking a different language,"said Bosshard.

Volunteers with Exit assisted 162 suicides last year, up from 154 a year earlier. The group accepts people who show clear judgment, who have consistently expressed a wish to die, and whose living situation is unbearable and unlikely to improve.

"Exit wants something like an official licensing for organisations in this field," Blum said. "The government should take this more seriously."

In Germany, laws regulating medical professions and drugs make it impossible to help a terminally ill person commit suicide, said Susanne Dehmal, spokeswoman for the right-to-die group Deutsche Gesellschaft fuer Humanes Sterben, or German Society for Dying in Dignity. The group tells members about going to Switzerland.

"They can be sure that relatives or friends assisting them don't have to fear legal retaliation," Dehmal said.

Dignitas helps patients to obtain a prescription for a lethal dose of the barbiturate natrium-pentobarbital, but the patient must ingest it himself, said founder and Chief Executive Ludwig Minelli on the group's website. Natrium-pentobarbital isn't available in Germany, Dehmal said.

Death Dignitas members pay 100 Swiss francs ($80) to join and an annual fee of 50 francs. Germans are required to join Dignitate-Deutschland, a group headed by Minelli that is lobbying for the right to assist suicides in Germany, for €95 ($190) plus €16 a month. Dignitas charges 2000 francs to help with a suicide.

In a speech, Minelli said accepting clients from countries that don't allow assisted suicide pressures those states to act. Neighbours of Dignitas don't want to wait for other countries to change their rules.

- BLOOMBERG