Select Committee on Assisted Dying for the Terminally Ill Bill Minutes of Evidence


Examination of Witnesses (Questions 2260 - 2279)

THURSDAY 3 FEBRUARY 2005

Dr Andreas Brunner and Mr Beat Sommerhalder

  Q2260  Chairman: I just wanted to be clear. I thought from what we heard yesterday that the criminal law is now in the Federation and in the Federation only.

Dr Brunner: We do not change anything in the criminal law. That is because we have big discussions also on these questions of helping suicide, of helping to death. Also, in the hospitals there are quite a lot of discussions and I do not think we will find a way forward in the next few years but perhaps I can make some remarks not on the criminal law, the liberal point of the suicide rules in the criminal law, but on the organisation and structure and financial points.

  Q2261  Chairman: You explained to us that when a death occurs other than for natural causes the police are informed and a level lower than the ordinary criminal level of investigation goes ahead. Is the report sent to you?

Dr Brunner: Yes. The normal criminal report but if the report is not clear then we open a normal criminal procedure. We have every year two or three of them.

  Q2262  Chairman: In that case what you are seeking to establish is whether or not the criminal law has been observed and followed in what was done.

Dr Brunner: Yes.

  Q2263  Chairman: There was a question we raised yesterday and perhaps this is a good time to ask you to deal with it please. That is that under Article 115 in your code a person who assists must have no selfish motive. We were wondering about the situation of an organisation that provides these services and helps, whether, for example, there is any financial consideration for their service and, if so, whether that has any effect on the rule that the person assisting must have no selfish interest in the suicide.

Dr Brunner: This is a very important point. That is also something in the law which has to be done. This organisation now in Switzerland can be an association without any control by the state or anyone. One of the points is that we want to have that in our regulations, that the organisations' financial transactions, each franc, each pound, that comes in and where from, have to be open, because that is a problem also. How much can you take for assisted suicide? I hear rumours from time to time that they take a lot of money but I have no proof of that. We are looking but at the moment we have no proof on that. I think that is very important. It is also very important to have in these organisations a good approved selection of people who are doing these assisted suicides because there is a danger from so-called angels of death. From time to time you have in hospitals, and I am sure you have had that also, persons who are killing a lot of people for pity or something like that. I think that is quite a danger and we have had persons in this for whom it becomes a little bit not only financially a business but also a mission to help people die and that is not good. They have to have a clear distance from that. I also mean that in our regulation it should say, for instance, that you must not have more than five to ten cases of assisted dying per year or something like that, to have it on a very low base so that in each case you help it is a very individual case and not, "Oh, where is the next case?". What you said on selfish points, I mention now too financial points. You have to open up all that, you have to make some regulations about what they are allowed to know. There are also people, when they are being helped, who make big donations to those societies. Should those societies be allowed to take donations like that? I can imagine that a man or a woman who wants to die might give quite a lot but also on the other side it is quite dangerous to have too much money for that. I think it is very important to have some regulations in this case.

  Q2264  Chairman: You have not made such regulations yet?

Dr Brunner: Nothing.

  Q2265  Baroness Jay of Paddington: I was going to ask you a general question before you get into the detail. As Lord Mackay said, that is very important to us in terms of framing regulations. I hope this does not sound negative. It sounds as though the concern about this has been stimulated by the increasing numbers, which are obviously of concern, of people coming to this country in order to take advantage of these organisations that exist here. Why has it taken people in the position that you are in, as it were, so long to see the necessity for regulation in this area?

Dr Brunner: Because I think it is not my problem. You did not shoot on me. I told that but it is a problem of the politician.

  Q2266  Baroness Jay of Paddington: No, but as you said to Lord Mackay, individual cantons can make regulations.

Dr Brunner: Yes. We have a parliament also in our country.

  Q2267  Chairman: These are the politicians?

Dr Brunner: Yes.

  Q2268  Chairman: Of whom you do not count yourself one?

Dr Brunner: And this has to pass the politicians also. Here you have the same spectrum of meanings as in the parliament of the country. It is quite difficult to make legislation in this case, to find a way where you can go.

  Q2269  Baroness Jay of Paddington: But is it right to say that the concern about this has been stimulated by the increase in the numbers of foreign people coming? For example, we had an informal discussion over dinner last night with some doctors who said that they felt that it was appropriate that this should be offered to foreigners because in Switzerland everyone was equal in terms of the kind of treatment they would receive, but from what I hear from you (and we have heard other people say this) it has really been the influx of people from other countries that has caused people here to look at the regulations.

Dr Brunner: Yes. Foreigners coming in the last few years have made the whole problem come up in discussions. That was one point. I am not against the foreigners coming and I think it would be not correct to put it like that. For me it is the procedure that this person comes today and dies the same day. Then I say that is also in Lord Joffe's Bill, to have to stay. That is not because it is a foreigner. Foreigners can die if they live in Switzerland or in Zu­rich also.

  Q2270  Baroness Jay of Paddington: But you would get over that problem if you legislated for it, for example, in the way that the other countries who offer this have done, which excludes people except if they are resident because then the concerns about people having a long term relationship with people and being—-

Dr Brunner: I think that is very important.

  Q2271  Baroness Jay of Paddington: Exactly. My basic question is, is that what really concerns you?

Dr Brunner: It sums up the whole problem. Before we had 20, 30 a year. It was "normal business" and we had quite a good relationship also with EXIT. They make really good things. They also send the persons to psychological institutes to control them and things like that. They are making that, what we need to have the law, but the new ones who have come up have made most of the problems for us. Under the new ones there is DIGNITAS which takes foreigners but there are little groups also; it is quite difficult.

  Q2272  Chairman: Little groups as well as DIGNITAS operating in Zu­rich?

Dr Brunner: Yes, but only a few, two or three. Even then they leave before the police come. They give the people the barbiturate and then they go and then a couple of days later the person is dead. That is also a problem that we have that could be one reason, that certain doctors give quite quickly the prescription for the barbiturate and then they do not care about people. They take it when they want.

  Q2273  Baroness Hayman: Can I just follow up that point because I have always found it slightly confusing? The law that does not prevent the assisting of suicide is a national law under the Penal Code, yet most of the conversations we have are around organisations involved in this. What I was trying to find out was whether there was practice going on that was between an individual doctor and an individual patient, perhaps in a country area where they are not involved with EXIT or one of the big organisations, and whether you feel there is unreported assistance that goes on as part of a physician/patient relationship separate from the organisations that, if you like, specialise in offering the service.

Dr Brunner: I am sure you are right and I am sure also that there is no demand for police in something like that. They make this as quite a normal death. That is a little bit the same problem we have also got in hospitals. I am sure that we have quite a lot of them who are doing that. I know that from friends of mine who are doctors. If there is a patient they discuss that together. I think that is the same in each country. I know also in Germany you do not have the possibility to do like here but I know from German doctors also that they are practising that. You make a very important point there.

  Q2274  Chairman: Here in this country it would be perfectly lawful for a doctor to assist in the suicide of his or her patient?

Dr Brunner: It depends.

Mr Sommerhalder: In most of the cases it is okay, yes.

Dr Brunner: Also, for example, if a man has Alzheimer's or something like that and they speak together and he says, "Come on, doc, now. It is time for me", I think that arises but I think also, as I said at the beginning, that very few doctors want to give the barbiturate because it is against the doctor's ethical position.

  Q2275  Chairman: It would be lawful for them to do it under the federal criminal law?

Dr Brunner: Yes.

  Q2276  Chairman: But you think that generally speaking anyway in Switzerland there is reluctance on the part of ordinary doctors, the GPs, to become involved in this process because they think it is outside the ordinary range of medical care? Is that right?

Dr Brunner: That is right.

  Q2277  Chairman: But there may be some who do it nevertheless.

Dr Brunner: There may be some, yes.

  Q2278  Chairman: I am right in thinking that where it happens it ought to be certified to the police, whether it is a doctor that does it or someone other than a doctor, but when a doctor does it he is supposed to certify—-

Dr Brunner: Also, yes, because it is not a normal death. You have to certify each not normal death.

  Q2279  Baroness Hayman: But the figures that you gave us were the figures for the organisations?

Dr Brunner: Yes.


 
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