Examination of Witnesses (Questions 2250
THURSDAY 3 FEBRUARY 2005
Dr Andreas Brunner and Mr Beat Sommerhalder
Q2250 Chairman: Thank you very much
indeed for having us here and being willing to give us some time
to help us in our inquiry into Lord Joffe's Bill which seeks to
change the law of England and Wales in relation to end of life
and assisted dying. We know that you have considerable experience
in this area in Zurich and perhaps also more generally and
we thought it would be very helpful to have your experience as
part of the evidence that we collect. The shorthand writer will
take a note of the evidence. We will submit the transcript to
you for review before it is published and then it will be appended
to our report and become general public property when the report
is published. If it is convenient for you what I thought might
be good would be for you to give us a shortish introduction on
your view on the matters relating to your experience of the area
we are concerned with and then my colleagues might wish to ask
questions of particular concern to them.
My Ladies, my Lords, welcome to Zurich. After the Second
World War Sir Winston Churchill was here in Zurich and had
his famous speech with the even more famous sentence, "Let
Europe arise". Perhaps this meeting serves also on another
subject to make Europe arise once more because in this case of
assisted suicide we would be grateful to have not just our regulation
but also some regulation in other countries on this subject. With
me today is the Prosecutor from the canton of Aargau, Mr Sommerhalder.
Aargau is between Berne and Zurich. You have travelled through
the canton of Aargau to get here and Mr Sommerhalder is here because
the organisation DIGNITAS, which you will visit this afternoon,
rented a house in Aargau to make assisted suicide available there
also, I think because they had too many problems with us. They
are now staying there and I am quite glad of this because you
were also at the Government yesterday and you saw Mr Stadelmann.
They thought at the Government that assisted suicide questions
were more or less the problem of the canton of Zurich which
has 1.2 million inhabitants rather than the problem of the whole
country. Now it has gone also to the canton of Aargau it has moved
up a little bit in importance to them. I am sorry I have invited
you to this room because we are reconstructing this 18th century
building and the other rooms are not perfect at the moment. My
English is not very good. Our interpreter is here if necessary
and we have to be very clear about what we mean on each word because
the terms are quite difficult and there could be some misunderstandings
which I hope will not occur. If I say something impolite to you
it is not impoliteness, just that I cannot do it better. I read
Lord Joffe's very interesting proposal for the Bill and also the
statements of Baroness Finlay, which make another point, and those
of the church. In our country it is mostly the Roman Catholic
Church which is totally against assisted suicide. I think a lot
of the proposals in Lord Joffe's Bill would be very important
if they were regulated in Switzerland also. If it is convenient
to you I thought we would stay about an hour here and then I shall
invite you to have a business lunch in the house across the road,
which is also a little bit related to our subject in a historical
grove, where we can speak together informally further on the subject.
Q2251 Chairman: That sounds very
Dr Brunner: I will
start by giving you the development of the Swiss law but I do
not wish to go over the same things you heard yesterday from Mr
Q2252 Chairman: You can take your
own line. You will have a way of putting it which will be your
own and I am sure we will listen with great interest.
Dr Brunner: In
Switzerland we have had a very liberal law since we made our penal
law in 1934. Under our Penal Code we have two Articles concerning
this subject. One is "homicide on request" and that
says that anyone killing a human being at his serious and urgent
request shall be sentenced with imprisonment for up to three years.
That is important in connection with suicide. When you are at
the limit from suicide it might make the difference to have assist
in suicide, that is to say that the man is doing the killing,
which was asked also in the case of Diane Pretty which everybody
knows about. The next one is assisted suicide, Article 115 of
our penal law, that is, that anyone, who for a selfish motive
shall help someone to commit suicide, shall be sentenced in a
penitentiary for up to five years if the suicide has been completed
or attempted. Those is the only law prescriptions we have; we
have no other prescriptions on suicide in any other law. When
the law was made in Switzerland we did not have any suicide organisations.
The meaning of assisted suicide was, for example, as a last duty
of friendship to help a person to die. In the late 1980s there
was the first suicide organisation was established here in Switzerland.
That was EXIT, and initially they had a couple of assisted suicides.
Now we have five or six organisations and some splinter organisations
also. They are people who worked in an organisation but who had
perhaps some problem with the organisation and have now set up
their own little organisation. Until the year 2000 there were
no big problems with that. In the early 1980s we made some processes
and we described that as murder and that was not at all, and then
that was quiet on the whole problem. Then in about 2000 suicides
of people from England started. We had out of the whole of Switzerland
in the canton of Zurich 26 Swiss people. I can give you
those afterwards. DIGNITAS started then with German people. I
do not want to go through all the years but the highest figure
was in 2003 when EXIT was about the same and DIGNITAS now had
a lot of people, 93, only two from Switzerland, the most from
foreign countries such as Great Britain. Our police do not make
a difference between England and Great Britain; I am sorry.
Q2253 Chairman: You are not unique
in that particular respect!
Dr Brunner: Last
year the numbers were a little bit deeper because we have now
the canton of Aargau where they are also going, and in Aargau
last year there were about 20 assisted suicides. Of British people
we have seven. In EXIT most of the assisted suicides are for Swiss
people. That is very important. They have from time to time one
from Germany, for example, but this person had acquired in his
life a close relationship to Switzerland or has his children here
or something like that. DIGNITAS went up from five (in 1999 there
were zero) to 93, so we have in total about 100 in Switzerland.
This year has started with a lot of assisted suicides. The normal
way of proceeding in assisted suicides in our country is that
the person who wants to have suicide will be a member of one of
these organisations. In the past it was important that the organisations
only gave help to dying persons. I make a difference between helping
a person to die and helping a person to suicide. Helping to die
refers to people who are incurably ill and very near the end of
life. That process would start quickly. Helping to suicide refers
to all other persons. That means the killing or homicide or help
to suicide of a person in whom this state of being near to death
is not yet reached. That means that with treatment their lives
can go on for months or even years, perhaps even more than ten
years. The third section in this category is the killing of people
who are old, who are afraid to be mentally ill or who have the
first beginnings of mental illness; they would receive help from
the organisation. That is all allowed in Switzerland. It is not
necessary that it is the first category, that is, the helping
to die. It is also free for persons who live longer but the doctor
has got to have a reason for that because people in our country
are taking a barbiturate and then they have to go a doctor who
gives a prescription. Also, concerning Lord Joffe's Bill, it is
important to see that you have very few doctors who want to give
those prescriptions. Normally they are doctors who have ended
their professional career who are doing that. For young doctors
it is quite difficult because the understanding for doctors is
to help people to stay alive. That is quite a big problem and
every organisation has a couple of these doctors. You see one
or two today, to help them, a doctor of confidence of the organisation.
That is quite difficult. For me the doctor should be quite neutral.
There have to be two doctors, not just the doctor of the organisation.
They speak with this doctor. Then they get the prescription. Afterwards
they are going to homes for elderly people in Zurich. That
is allowed; it is two years ago but there were only six persons.
There was no problem. Or mostly they are foreigners in one of
the apartments of the organisation. You will hear about the process
this afternoon, that they are coming in, they are speaking once
more and then after a couple of times they are drinking that barbiturate
and finally, when they are dead, the people have to inform the
police because it is not a normal death. We have that as a control
and the police come with the forensic physician and the public
prosecutor. That is not a normal penal procedure. We are coming
only afterwards and that makes quite a lot of problems. They show
us a couple of documents, like the suicide declaration, the medical
diagnosis and all that. We want also now to have from the medical
that they have capacity of judgement. That is very important.
They make also a processing record of that. Now perhaps what we
have most problems with are the people who are paralysed who have
to have some infusion or stomach catheter. That is concerning
the Article on homicide on request because it is very important
in our country that the human being committing suicide is doing
the last act himself or herself. Normally they drink the cup or
with the infusion and they have to be capable of turning around
here and doing a little bit of other things, which is quite difficult
because they are really ill people sometimes. Another really difficult
case is mentally ill persons, normally mentally ill or more than
starting with Alzheimer's disease. There are three positions of
Alzheimer's disease. Now we are making a process for when Alzheimer's
disease is too advanced so that the person is no longer conscious
of what he is doing. That is quite a difficult section. On the
other side we have to see also that there can be mentally diseased
persons who can be from time to time for a period in a good condition,
and then we say lastly that it can be possible that this person
can be assisted to suicide. Another problem is double suicides.
We get from time to time double suicides, say, a couple who have
lived 50 years together or a sister and brother. Here you have
big problems because if I am in a couple or in a relationship
and I ask him, "Shall we go to the cinema today?", and
he says, "Oh, no, I prefer to go to the opera", and
I say, "Come on, let us go to the cinema", it is a discussion
and one person has more influence than the other. I was once in
my profession doing a little bit of politics also and we had a
letter from a couple who announced that they were going to have
assisted death a few days later. When they wrote that I thought,
"I have to visit them". I visited them. It was a couple
in their eighties. He had cancer of the prostate and I saw that
the lady had spent 50 years doing what her husband wanted. When
her husband said, "Come on, darling, let's go", she
said, "Yes". I tried to tell her that I knew a couple
of widows who were quite happy afterwards. There is a restart
of life for someone like that. I only want to show that the double
suicides are a big problem. Then we have problems with foreigners.
The normal way is that they come from other countries. They have
some written contact with the organisations and they arrive one
day by plane or by car or train in Zurich or Aargau and
the same day or the day afterwards they are committing suicide
with assistance. For me it seems they had pressure first from
the journey to come here, and also they came on several occasions
with television teams or writers or whatever, but also, if they
come alone when they are in this room they feel a pressure to
go. That is quite a problem. For me that means that the explicit
wish to die has to continue over some time. If I may make this
remark, those 14 days you have in your proposal, Lord Joffe, is
a very short time and it would be good to think that over once
more perhaps, because it is very important to say that apart from
mental problems people have dips in their lives. One day you want
your life, the next day not. My mother is 85. She is in good condition
but there are periods when she says, "I want to die. My husband
is dead. I do not have anything to do". Two days afterwards
she has a great concert and she is happy". In old people
it is like that. You have got phases. You are in a dip, you are
low, and then you go up and life is beautiful. We have that also
and it is very important that we do not get persons to suicide
who are in a phase like that in my opinion. Perhaps now you can
ask some questions and then I will show you what I think we have
to do as law in the canton of Zurich because I have prepared
the law a little bit to have some regulations and if Switzerland
does not do this we will prepare in the canton of Zurich
such a law, we will make such a law to put some pressure on the
country. It is stupid when we make a law. We need to make a law
in all Switzerland but to put some political pressure on we will
make a law.
Q2254 Chairman: That is quite an
interesting and important point to explore. I think I am right
in saying that the criminal law is now federal Swiss law?
Dr Brunner: Yes.
Q2255 Chairman: And the Articles
you referred to are from the Swiss Penal Code which rules in Aargau
and in Zurich and everywhere else?
Dr Brunner: Yes.
Q2256 Chairman: What I am not clear
about from what you have just been saying is this. You can have
pressure from Zurich or from Aargau or from other cantons
on the Federation to change the criminal law for the Federation
but if you cannot persuade the Federation to act are you still
able in the canton of Zurich itself to promote a criminal
law which will govern what takes place in Zurich?
Dr Brunner: Yes.
I understand your question quite well. I do not want to change
the criminal law. We cannot do that. The criminal law has to be
changed by the Confederation but we can have a law of authorisation
and monitoring of those organisations. That is not criminal law.
Q2257 Chairman: That is administrative
law, would you say?
Dr Brunner: Yes.
Q2258 Chairman: You can make administrative
law arrangements and there are administrative law tribunals, are
there not, in Switzerland distinct from the criminal court?
Dr Brunner: That
Q2259 Chairman: And these tribunals
could, for example, administer a registration or regulation system
for a given organisation like EXIT or DIGNITAS?
Dr Brunner: Yes.
Every canton could do that also.