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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