Regulations on prescribing and issuing sodium pentobarbital are sufficient

Federal Department of Justice and Police

Berne, 29.08.2007 - Regulations governing the prescribing and issue of the anaesthetic sodium pentobarbital are sufficient. Swiss drugs legislation does not require any stricter rules to prevent possible abuses in cases of assisted suicide. That is the conclusion reached by the supplementary report on euthanasia that the Federal Council acknowledged on Wednesday.

Assisted suicides involve risks of abuse on several fronts. There may be pressure, coercion, threats or deception by third parties, or the person concerned may not be capable in legal terms of making the associated decisions. Cases like these result not in a suicide, but in a homicide. The person assisting the suicide may also be motivated by self-interest. The Federal Department of Justice and Police (FDJP) therefore joined forces with the Federal Department of Home Affairs (FDHA) to examine whether or not the prescribing and issue of lethal doses of sodium pentobarbital might be made subject to stricter requirements through a revision of Switzerland's drugs legislation. All of the options that were reviewed proved unviable, however.

• The doctor could be required by law to investigate the patient's state of health and desire to die in depth or on several different occasions and, where necessary, to bring in further specialists. This would nonetheless contradict the principle that the prescribing and issue of medical drugs is not governed in detail in the statute books, but should instead observe recognised rules of medical science.
• Sodium pentobarbital might be issued exclusively to assisted suicide organisations, to prevent the use of any residual amounts by third parties, for example. However, this approach would not offer any guarantee that these organisations would properly and effectively carry out the role they had been given.
• Sodium pentobarbital might be reclassified under secondary drugs legislation. This would simply result in deliveries of the drug having to be reported (i.e. an ex-post check), and would therefore not be able to prevent abuse.
• While the sodium pentobarbital was being administered, doctors might be obliged to monitor whether the patient was committing suicide of their own free will or being killed by a third party. Such "policing" duties are not part of the doctor's remit, however.

Action under supervisory law in the event of a breach of duty

The supplementary report emphasises that the present statutory provisions and codes of conduct are sufficient, and compliance with them is monitored by the competent cantonal supervisory bodies. If a doctor fails to fulfil their duty (e.g. by not examining a patient thoroughly), the supervisory authority will take the necessary action, which might extend to the withdrawal of the doctor's licence to practise. Furthermore, the cantonal prosecuting authorities will instigate the necessary steps if a criminal act is suspected.

Strengthen research into palliative care

The supplementary report also provides a summary of the action that has been taken to date and has been planned for the future to promote palliative solutions. In addition, the FDHA will submit proposals to the Federal Council on strengthening research into palliative care.

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