title: Suicide tourism: a pilot study on the Swiss phenomenon.
abstract: While assisted suicide (AS) is strictly restricted in many countries, it is not clearly regulated by law in Switzerland. This imbalance leads to an influx of people-'suicide tourists'-coming to Switzerland, mainly to the Canton of Zurich, for the sole purpose of committing suicide. Political debate regarding 'suicide tourism' is taking place in many countries. Swiss medicolegal experts are confronted with these cases almost daily, which prompted our scientific investigation of the phenomenon. The present study has three aims: (1) to determine selected details about AS in the study group (age, gender and country of residence of the suicide tourists, the organisation involved, the ingested substance leading to death and any diseases that were the main reason for AS); (2) to find out the countries from which suicide tourists come and to review existing laws in the top three in order to test the hypothesis that suicide tourism leads to the amendment of existing regulations in foreign countries; and (3) to compare our results with those of earlier studies in Zurich. We did a retrospective data analysis of the Zurich Institute of Legal Medicine database on AS of non-Swiss residents in the last 5 years (2008-2012), and internet research for current legislation and political debate in the three foreign countries most concerned. We analysed 611 cases from 31 countries all over the world. Non-terminal conditions such as neurological and rheumatic diseases are increasing among suicide tourists. The unique phenomenon of suicide tourism in Switzerland may indeed result in the amendment or supplementary guidelines to existing regulations in foreign countries.
authors.affiliation: Institute of Legal Medicine, University of Zurich, Zurich, Switzerland.
authors.forename: Saskia
authors.initials: S
authors.lastname: Gauthier
authors.affiliation: Centre for Medicine-Ethics-Swiss Law, Institute of Jurisprudence, University of Zurich, Zurich, Switzerland.
authors.forename: Julian
authors.initials: J
authors.lastname: Mausbach
authors.affiliation: Psychiatric Clinic, Centre for Psychiatry, Münsingen, Switzerland.
authors.forename: Thomas
authors.initials: T
authors.lastname: Reisch
authors.affiliation: Institute of Legal Medicine, University of Zurich, Zurich, Switzerland.
authors.forename: Christine
authors.initials: C
authors.lastname: Bartsch
mesh_terms: D000047:Academies and Institutes; D000328:Adult; D000368:Aged; D003431:Cross-Cultural Comparison; D005260:Female; D005602:France / Q000453:epidemiology; D005858:Germany / Q000453:epidemiology; D006291:Health Policy / Q000331:legislation & jurisprudence*; D006297:Health Services Accessibility / Q000331:legislation & jurisprudence*; D006801:Humans; D008297:Male; D057193:Medical Tourism / Q000331:legislation & jurisprudence; D016743:Mental Competency; D008875:Middle Aged; D028701:Patient Rights / Q000331:legislation & jurisprudence; D010865:Pilot Projects; D017236:Suicide, Assisted / Q000941:ethics / Q000331:legislation & jurisprudence* / Q000706:statistics & numerical data; D013557:Switzerland / Q000453:epidemiology; D006113:United Kingdom / Q000453:epidemiology
keywords: End-of-life; Forensic Medicine; Suicide/Assisted Suicide