Assisted suicide is a hotly debated topic, raising numerous medical-ethical questions. The SAMS has long been concerned with this subject. In the guidelines on «Management of dying and death», a separate section is dedicated to assisted suicide. The SAMS thus provides a sound medical-ethical framework for physicians who have to make complex case-by-case decisions on assisted suicide.
When persons with capacity request medical professionals for support in bringing about their own death, this represents a highly challenging situation. A desire for death must be taken seriously and respected. At the same time, each physician must be able to decide freely whether or not they wish to perform assisted suicide. Anyone who decides to do so bears a substantial responsibility – from a medical and an ethical perspective. The SAMS guidelines offer medical-ethical guidance for those members of the medical profession who are in principle prepared to perform assisted suicide.
Since the late 1990s, there has been a marked increase in deaths by assisted suicide as a proportion of all deaths occurring in Switzerland – from 0.2% in 1999 to 2–3% today. This growing «normalisation» may lead to certain groups or individuals feeling under pressure to end their lives prematurely – for example, because they believe themselves to be a burden, or a drain on resources. The duty to care for and protect vulnerable persons involves an obligation to take appropriate measures to prevent them from feeling pressured into assisted suicide.
Specific topic pages
FAQ
How does assisted suicide work? Do the terms «end-of-life care» and assisted suicide mean the same thing? You can find answers to these and other questions in our FAQ.
Organ donation after assisted suicide
Hospitals occasionally receive inquiries about whether organ donation is possible following assisted suicide. Although this concerns only a small group of individuals and no transplant center has so far carried out postmortem organ donations after assisted suicide, the Central Ethics Committee (CEC) of the Swiss Academy of Medical Sciences considers it important to reflect on the associated ethical and legal questions. For this reason, it published a statement in 2025 describing the medical-ethical and professional-ethical challenges involved. In addition, in 2026 the SAMS commissioned a legal opinion examining the actual legal admissibility of organ donation following assisted suicide. Further details can be found on our topic page Organ donation after assisted suicide.
Legal framework for assisted suicide in Switzerland
In Switzerland, there is no national law on assisted suicide. The legal framework is defined by the Swiss Criminal Code and the Narcotics Act. Assisted suicide is permissible in Switzerland provided that the person seeking suicide has capacity and performs the final act leading to death him/herself, and the person rendering assistance does not act from selfish motives. This means that assisted suicide is not prohibited even in the case of healthy individuals, or minors with capacity.
In practice, however, assisted suicide is subject to more stringent conditions, based on self‑regulation – on the one hand, the rules of the assisted suicide organisations (e.g. association by-laws) and, on the other, the SAMS guidelines on «Management of dying and death». These guidelines deal with medical-ethical aspects of assisted suicide and describe in general terms the duties of care associated with professional ethics. They form part of the Code of the Swiss Medical Association (FMH) and are binding for its members.
Both the above-mentioned association by-laws and the guidelines can be modified by the organisations in question. In the case of SAMS guidelines, this process is specified in the Regulations of the Central Ethics Committee (CEC) (available in French / German) and is subject to defined quality assurance and review procedures.
The role of physicians
In Switzerland, assisted suicide is largely handled by private organisations in this field. In the vast majority of cases, it takes place outside of healthcare institutions. However, the medical profession is involved in two ways:
- Assisted suicide requires the administration of a lethal drug (phenobarbitone sodium, PBS), which can only be prescribed by a physician.
- The capacity of the person seeking suicide must be assessed, generally by a physician.
Physicians are thus inevitably involved in assisted suicide. If they are confronted with a request for assisted suicide, nuanced, case-by-case decision-making is called for. Guidance is provided by professional ethics – in particular, Section 6.2.1 («Assisted suicide») of the SAMS guidelines on «Management of dying and death».
The guidelines emphasis that a desire for death must be taken seriously. Physicians have a duty to listen and seek to identify the reasons underlying the desire for death. Their responsibilities include the alleviation of symptoms, provision of support for patients and discussion of alternatives to suicide. There is no duty to provide assisted suicide – physicians are not obliged either to perform it or to offer it proactively.
Medical participation in assisted suicide and professional ethics
If patients ask physicians for assistance in ending their own lives, this poses a profound challenge to the medical professionals’ understanding of their role in terms of professional ethics. At issue is their autonomy in the exercise of their profession: individual physicians must be able to decide for themselves whether or not to perform assisted suicide. At the same time, empathy and compassion for the person wishing to die are also called for – attitudes which are likewise an integral part of the physician’s professional ethics.
Before performing assisted suicide or writing the necessary prescription, physicians must make sure that this decision is for the benefit of the person concerned. This requires a relationship of trust and respect, involving compassion and judgement. The physician’s action is based on careful reflection: on the one hand, autonomy and hence also the desire for a self-determined death are to be respected; at the same time, protection from abuse and prevention of coercion of particularly vulnerable individuals must always be assured. The aim is to arrive at a well-considered decision through a well-founded, respectful dialogue.
The SAMS General Secretariat does not provide counselling on assisted suicide to individuals. For counselling, please contact your general practitioner or your treating physician (e.g. an oncologist, psychiatrist or neurologist).
Requirements for assisted suicide justifiable from a medical-ethical perspective according to the guidelines
At the centre lies the dialogue with the person seeking suicide. The guidelines – other than in justified exceptional cases – require at least two detailed discussions to be conducted, separated by an interval of two weeks. If the desire for death persists in a person who has been carefully informed and assessed, assisted suicide is considered to be ethically justifiable according to the SAMS guidelines provided that all of the following four requirements are met.
- Capacity: The person seeking suicide has capacity;
- Self-determination: The person has an autonomous desire to die, which is well‑considered and not due to external pressure;
- Severe suffering: The person is experiencing intolerable suffering. This involves medically definable severe symptoms of disease and/or functional impairments, and the expression of intolerability is comprehensible for the physician;
- Consideration of alternatives: Possible alternatives have been explored and have proved inappropriate or been rejected by the person seeking suicide.
The first two requirements – capacity and self-determination – must additionally be confirmed by an independent third party, who need not be a physician.
In connection with assisted suicide, notification duties exist: the prescription of the lethal drug (PBS) must be reported to the relevant cantonal authorities within 30 days, and death as a result of assisted suicide must be immediately reported as an unnatural death.
Further reading on the assisted suicide section of the SAMS guidelines
SÄZ/BMS: Forum contribution by Paul Hoff, Chair of the Central Ethics Committee of the SAMS. «Assisted suicide: not essentially a medical responsibility» (p. 22; available in French / German) (14 August 2024)
SÄZ/BMS: Article by the FMH legal department. «Clarification of jurisprudence on assisted suicide» (pp. 36–37; available in French / German) (14 August 2024)
SÄZ/BMS: Interview with Paul Hoff, Chair of the Central Ethics Committee of the SAMS. «We want to promote ethical sensitivity among physicians» (available in French / German) (17 August 2022)
SAMS Newsletter: Guidance on end-of-life treatment and care (19 May 2022) (available in French / German)
Societal and political debate on assisted suicide
Questions concerning the eligibility criteria for assisted suicide are continuously debated. The SAMS considers it essential that there should be a comprehensive discussion within society of how assisted suicide is to be understood and ethically evaluated. While the perspectives of the medical and other health professions provide central points of reference, they are not sufficient for a definitive assessment. It is a matter for society to determine whether, for example, assisted suicide should be accessible for healthy individuals or for minors, and what implications this would have for all concerned.
Also to be carefully considered is the question of what safeguards are required for vulnerable groups, so as to ensure that people do not feel pressured into assisted suicide. In addition, it must be discussed how self-determination is to be assured in each individual case and how possible abuses can be effectively prevented.
These questions are also a matter of political debate. As a member of the association of Academies, the SAMS has a responsibility to promote dialogue between scientists, policymakers and administrative bodies. One established forum for dialogue is Science et Politique à table!. Here, the Swiss Academies of Arts and Sciences invite parliamentarians from the National Council and the Council of States, as well as members of party secretariats, to discuss current topics with leading scientists. The event held on 4 March 2025 was concerned with assisted suicide. The documentation can be downloaded here.