Mr. Silvan Luley:

I would have to look it up as I do not know it by heart but the committee needs to know that we have had the practice for 40 years. One point where I disagree with Professor Boer is that I do not think it makes a difference whether you legalise assisted suicide or voluntary euthanasia. Regarding the argument that voluntary euthanasia would lead to more deaths by assisted dying compared to assisted suicide, it involves many other factors such as culture, society, how people feel about self determining life and the end of life. I am not sure if there is research around that but I doubt that beyond legalising assisted suicide, voluntary euthanasia would lead to more unnatural death figures.

I will extend this point. Let us face it. Our modern healthcare system and modern medical science have given rise to the issue of assisted dying. Modern medical science is now able to prolong life beyond natural death. There is no such thing as a natural death anymore. It no longer exists. You can keep a person who is brain dead and is not a personality anymore alive. Medical science can do that. In that sense, there is hardly a natural death. Of course human beings are programmed to live. We cling on to any possibility of prolonging our lives as long as the quality of life is in line with what we want. Medical science offers that. Life expectancy has doubled over the past 100 to 150 years to reach over 80 in most western societies so we caused the problem ourselves with the development of medical science. That is a blessing but the other side of the coin is that people can make use of healthcare to prolong their lives but they might not have the quality of life they want. This is why they might turn to assisted dying.

When the constitutional court in Austria legalised assisted suicide, it made an important point. It asked what the difference was between a doctor based on the advance healthcare directive of a patient switching off a life-prolonging action and a mentally competent individual making use of assisted suicide. There is no difference. In both cases, it is a third person intervening based on the will or wish of the person. In the case of advance healthcare directives, an earlier piece of paper that says that a person does not want his or her life prolonged - in some cases, based even on the presumed will of the patient - so we already intervene in the ending of life on a daily basis in hospitals, hospices and care homes. In that regard, there is no difference between that and a doctor prescribing lethal medication for a patient to end his or her own life or even voluntary euthanasia.

In earlier days, there was competitive thinking between palliative care and assisted dying. This happens in other countries that, like Switzerland, have a 40-year model of development of co-operation between non-profit organisations like Dignitas and medical doctors. It has developed and changed in Switzerland and over the years, more and more palliative care doctors directly co-operate with organisations like Dignitas for the benefit of the patient. We have a palliative care doctor in a hospital nearby. A man from Germany came to us for assisted suicide and on the last day, he was so weak and his veins from chemotherapy were so bad, it would not have been possible to insert a needle with the Pentobarbital. He would not have had the strength to open the vial so we spoke to a palliative care doctor and transferred the patient to the palliative care ward of the nearby hospital. It took care of him based on the advance healthcare directive and the patient passed away within a few days with palliative care and continuous deep sedation on that palliative care ward.

That is how it works in Switzerland more and more. In the French part of Switzerland, it is a common thing that our colleagues would go to contact assisted suicides in the hospital in co-operation with palliative care doctors and family and so on.