GESTIÓN EN SALUD PÚBLICA: BioEdge: Switzerland: Minelli cleared; doctors OK to help in assisted suicide

domingo, 10 de junio de 2018

BioEdge: Switzerland: Minelli cleared; doctors OK to help in assisted suicide

BioEdge: Switzerland: Minelli cleared; doctors OK to help in assisted suicide

Bioedge

Switzerland: Minelli cleared; doctors OK to help in assisted suicide

by Michael Cook | 9 Jun 2018 | 1 comment

The founder of Switzerland’s best known assisted suicide group, Dignitas, has been cleared of charges of “profiteering” from helping people to die.

The public prosecutor contended that that the 85-year-old Minelli had used "unauthorised commercial tactics" and charged "high fees which bear no relation to actual cost". Under Swiss law, assisted suicide is legal only if there are no “self-serving motives”. But a district court in Zurich found that the prosecutor had not been able to prove that there were selfish motivations in Minelli's case. It ordered the prosecutor to pay Minelli’s costs – about CHF135,000 ($136,000).

In another development, the Swiss Academy of Medical Sciences (SAMS) has taken a more favourable view of assisted suicide in its revised code of conduct. The 2004 version of the codestates that:

With patients at the end of life, the task of the doctor is to alleviate symptoms and to support the patient. It is not his task to directly offer assistance in suicide, he rather is obliged to alleviate any suffering underlying the patient’s wish to commit suicide.

This did not rule out assisting suicide, even though it was legal for non-physicians, but it made it clear that it was not part of a physician’s responsibilities.

However, this year’s revision incorporates some subtle changes:

The role of physicians in the management of dying and death involves relieving symptoms and supporting the patient. Their responsibilities do not include offering assisted suicide, nor are they obliged to perform it. Assisted suicide is not a medical action to which patients could claim to be entitled; it is, however, a legally permissible activity. It can be performed by physicians if they are convinced that the requirements given below are met.

The new version implies that assisted suicide would be considered a normal part of a physician’s job, although he retains the right to conscientious objection.

The code also gives some sketchy guidelines, for the first time, about how Swiss doctors should approach voluntary stopping eating and drinking (VSED). The ethical problem arises when a patient embarks upon VSED even though he or she is not dying. The new code asserts that whether this decision should be supported depends upon “the values of the health professionals concerned”.

Sunday, June 10, 2018

The deaths this week of fashion designer Kate Spade and celebrity chef Anthony Bourdain (see below) focused the media once again on explanations for America’s rising suicide rates. The short answer is: nobody knows. The more nuanced long answer is: nobody knows for sure. But something is driving it. Here are a few paragraphs from the New York Times which suggest that suicide is becoming culturally more acceptable:

The rise of suicide turns a dark mirror on modern American society: its racing, fractured culture; its flimsy mental health system; and the desperation of so many individual souls, hidden behind the waves of smiling social media photos and cute emoticons.

Some experts fear that suicide is simply becoming more acceptable. “It’s a hard idea to test, but it’s possible that a cultural script may be developing among some segments of our population,” said Julie Phillips, a sociologist at Rutgers.

Prohibitions are apparently loosening in some quarters, she said. Particularly among younger people, Dr. Phillips said, “We are seeing somewhat more tolerant attitudes toward suicide.”

In surveys, younger respondents are more likely than older ones “to believe we have the right to die under certain circumstances, like incurable disease, bankruptcy, or being tired of living,” she said.

If this is the case, why, O why, is there a movement for assisted suicide? Yes, it’s hard to prove, but it makes sense: if assisted suicide is a triumph of compassion and autonomy, how can unassisted suicide possibly be a tragedy?