“Unbearable suffering” could be the new standard

The Federation of Swiss Medical Doctors (FMH) has refused to include in its code of ethics new guidelines on end-of-life care proposed developed by the Swiss Academy of Medical Sciences (SAMS). These provide that a physician may practice assisted suicide for patients presenting with “unbearable suffering” related to the symptoms of an incurable disease or disability. Until now, the patient had to have a terminal illness.

The FMH believes that unbearable suffering is too vague as a criterion. Michel Matter, a FMH vice president, gave the example of a bipolar patient. “When she is in a low phase, such a person would fulfil this condition of unbearable suffering, but not when she is in a high phase.” For him, doctors must protect the most vulnerable patients and whose situation is not always clear. “By defending the weakest, the FMH is in step with society,” he concluded.

Samia Hurst, of the University of Geneva, who participated in the development of the guidelines, criticised the decision of the FMH. “This test of unbearable suffering is found in many jurisdictions about voluntary death.” She added that “Physicians already practice assisted suicide outside end-of-life situations (for example, by accompanying, for example, elderly people with multiple pathologies). The new directives of the SAMS frame these situations, while the old ones did not. “

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Michael Cook

Michael Cook edits BioEdge, a bioethics newsletter, and MercatorNet, an on-line magazine whose focus is human dignity. He writes from Sydney, Australia.

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