MOSCOW, May 14 (RAPSI), Ingrid Burke - A lack of clarity in Switzerland’s assisted suicide law has risen to the level of a rights violation in the case of an elderly albeit healthy woman wishing to end her own life, the European Court of Human Rights (ECHR) held Wednesday.
Lamenting the declining states of physical and mental health that tend to accompany the aging process, applicant Alda Gross (b. 1931) has for years expressed the desire to end her own life. A failed suicide attempt in 2005 landed her in a psychiatric hospital.
While six months of treatment did little to combat her desire to die, it served as motivation to seek legal legitimacy in her efforts. For assistance, she contacted assisted-death advocacy group EXIT, which informed her that given the circumstances it would be difficult to find a doctor willing to prescribe the lethal drug.
In 2008 a psychiatrist submitted an expert opinion asserting Gross’ capacity to form her own decision on the matter. As explained by the judgment, the psychiatrist had found that while Gross had never suffered any major illnesses or undergone any devastating surgeries, she had suffered a decline in her physical and mental capacities in recent years. She complained that her memory and focus had deteriorated, and that she was no longer able to take long walks. Having lost a number of friends over the years as well as the ability to undertake activities she had once enjoyed, Gross asserted that life had become increasingly monotonous. These issues were exacerbated by eczema, backaches, and the discomfort of not feeling able to express her wish to die amongst her friends.
Although he had no qualms with her mental capacity to arrive at such a decision, or with the underlying rationale, the psychiatrist declined to issue a prescription for fear of blurring the lines between medical expert and treating physician.
Gross then reached out to various medical practitioners. One declined based on concerns that issuing a prescription in this case would be repugnant to the Code of Medical Ethics due to Gross’ lack of any serious illness. A second offered to meet with Gross about the potential issuance of a prescription pending the guarantee of Gross’ counsel that she would not risk any consequences in light of the Code of Medical Ethics. As Gross’ counsel could not provide such guarantee, the second practitioner declined.
Gross then took her fight to the Health Board of the Canton of Zurich, appealing to the board to provide her with the relevant drugs based on her failure to find a willing practitioner. Several months later, in April 2009, the board rejected her request based on the finding that neither the Swiss Constitution nor the European Convention of Human Rights (Convention) could be read to require a state to provide a patient with the means to end his or her own life.
Gross then appealed the decision with the Administrative Court of the Canton of Zurich. In October 2009, the court rejected the appeal based on the finding that the psychiatrist who initially asserted Gross’ mental capacity to render the decision had not fulfilled all of the prerequisites necessary for issuing a prescription, such as determining the existence of any underlying diseases. Thus, further medical examination would be necessary.
Appealing once again, Gross continued to seek the lethal prescription, but further asked the Federal Supreme Court to declare that the provision of a lethal prescription to an aging but otherwise healthy person would not violate the Code of Medical Ethics.
The Federal Supreme Court ultimately rejected the appeal, holding that states are not obliged to provide citizens with dangerous substances in order to accommodate the wish to die. Furthermore, it established that the tricky ethical questions of whether and when patients should be provided with lethal prescriptions was primarily one for the legislature, noting that the relevant legal reform was currently the subject of political debate.
In November 2010 Gross turned to the ECHR, charging that the refusal by Swiss authorities to accommodate her request constituted a denial of her right to decide the means and circumstances of the end of her life in violation of Article 8 of the Convention, which guarantees the right to respect for private and family life.
The court agreed that the case fell within the scope of Article 8, noting in Wednesday’s judgment: “the notion of ‘private life’ within the meaning of Article 8 of the Convention is a broad concept, which encompasses, inter alia, the right to personal autonomy and personal development… Without in any way negating the principle of the sanctity of life protected under the Convention, the Court has considered that, in an era of growing medical sophistication combined with longer life expectancies, many people are concerned that they should not be forced to linger on in old age or in states of advanced physical or mental decrepitude which conflict with strongly held ideas of self and personal identity.”
Accordingly, the court asserted that Gross’ wish to be provided with the lethal prescription for purposes of ending her own life falls within the scope of Article 8’s protection of private life.
The judgment blamed a lack of clarity in legal guidelines surrounding assisted suicide, concluding that: “Swiss law, while providing the possibility of obtaining a lethal dose of sodium pentobarbital on medical prescription, does not provide sufficient guidelines ensuring clarity as to the extent of this right. There has accordingly been a violation of Article 8 of the Convention in this respect.”
While the court acknowledged that political consensus on such matters may prove trying, it concluded that such troubles are “inherent in any democratic process and cannot absolve the authorities from fulfilling their task therein.”