Suicide Tourism: A one way ticket to Euthanasia Central

Germans are flocking across the border to Switzerland looking for the right to die. Switzerland is one of the few European countries where euthanasia is legal. Since 1942, Swiss doctors can terminate a life if three conditions are satisfied: documented proof of the existing disease, the lack of protest from relatives and a signed contract, confirming that the decision is voluntary and invariable. Because the service is not limited to Swiss citizens, a suicidal tourism trade has developed for those who don’t need the money for a return ticket. Four companies have been set up to perform the service for about €5,000 and one of the companies Dignitas say that 120 of their 196 customers in 2006 were from Germany where the laws are tougher.

Germany is not the only jurisdiction that is less forgiving than the Swiss. In the Canadian province of Saskatchewan, Robert Latimer is serving a life sentence for killing his disabled daughter during what he says was an act of compassionate euthanasia. Latimer openly admitted his “guilt” and two juries convicted him of second-degree murder in the 1993 death of his 12 year old daughter, who was a 12 year old quadriplegic functioning at the level of a three-month-old. Latimer killed her by leaving her in his truck with the motor running and a hose from the tail pipe extended into the cab, while the rest of the family was at church. Critics of leniency for Latimer worried that a Supreme Court “soft” decision would send a signal that euthanasia was acceptable. The Supreme Court upheld the life decision in 2001.

Mercy killing is also illegal in India. In 2004, the Andhra Pradesh High Court rejected a plea from K. Venkatesh, a former national chess champion battling a neurological disorder, who asked to be taken off his life support system. Because of Venkatesh’s case and others, an MP named C.K. Chandrappanhas introduced the Euthanasia (Permission and Regulation) Bill, 2007, in the Indian parliament. If passed, it would provide for a humane and painless death of an individual suffering from an incurable disease. “If there is no hope of recovery for a patient, it is only humane to allow him to put an end to his pain and agony in a dignified manner” said Chandrappanhas.

The Indian bill has incurred the wrath of right to life groups such as the Bangalore-based Respect for Life India. They say the bill is unacceptable both from an ethical and moral standpoint. Right to lifers emphasise the “killing” aspect of euthanasia. According to the ACT Right to Life Association in Canberra the choice is stark “for euthanasia to occur, there must be an intention to kill.” They claim palliative care can now effectively relieve almost all severe pain and significantly relieve emotional distress.

But long-time voluntary euthanasia campaigner Philip Nitschke disagrees. Nitschke was instrumental in the short-lived Northern Territories legislation that was the world’s first Voluntary Euthanasia (VE) law in 1996. Under this law a terminally ill person could to get help from their doctor to die. Four of Nitschke’s patients used this law in the eight months before it was overruled in the Federal Parliament. Nitschke believes the law was overturned by “godbotherers” and a fundamentalist, all-denomination Christian lobby that are small in number but large in influence.

Nitschke is a doctor and therefore well aware that euthanasia is not mentioned explicitly in the Hippocratic Oath. The closest it has to say on the subject is “I will give no deadly medicine to any one if asked, nor suggest any such counsel”. Nor is the position of international human rights law on the matter explicit or clearly defined. Article 6(1) of the International Covenant on Civil and Political Rights (ICCPR) provides: “Every human being has the inherent right to life. This right shall be protected by law. No one shall be arbitrarily deprived of his life.” Roman law and later English common law forbade both suicide and assisting suicide.

The arguments around euthanasia took on a new meaning in the 19th century with the availability of anaesthesia. New York was the first legislature to specifically ban the practice. Today some of the most liberal laws apply in the Netherlands where doctors have immunity from prosecution providing they have complied with a number of 'rules of careful practice'. Dutch acceptance of this practice has been put down to a number of factors including a mature public discussion of moral issues, a secular society, a sense of individual responsibility, the Royal Dutch Medical Association's approval, trust for the medical profession and universal medical coverage.

Euthanasia raises ethical, moral, religious, philosophical, legal, constitutional and human rights issues. Common arguments against include the danger that euthanasia is not only restricted to the terminally ill, it can be used as a health care cost containment, people could be pressurised into accepting it, and it is a rejection of the importance and value of human life. Meanwhile those in favour cite the unbearable pain of sufferers, the right to facilitate the end of this suffering and forcing people to stay alive against their wishes. According to deacon Michael Pershin, a priest of the Moscow Patriarchy, “the phenomenon of euthanasia becomes possible when the meaning of life is pleasure”. According to Nitschke, it's "an absolutely vital and important decision that an individual has".