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According to the Swiss Criminal Code, assisted suicide is illegal only if done “for selfish motives.” While in other jurisdictions only physicians are allowed to engage in the practice of assisted death, in Switzerland the actual assistance in suicide can and usually is performed by non-physicians. This chapter examines the role of several right-to-die organizations that offer the service of assisted death. Among these, Exit-German Switzerland stands out as operating in a fairly responsible manner, while the organization Dignitas caters to suicide tourism from other countries and often is charged as operating for profit. While the law requires a doctor's prescription for the lethal medication that is used by patients committing suicide, medical scrutiny appears to be slight. For the year 1996, for example, Exit reported an acceptance rate of 86%, which contrasts with 37% of granted applications by doctors in the Netherlands. While the Swiss public is broadly supportive of the practice of assisted death, there has developed concern about the lax rules that govern the practice of assisted death by Swiss right-to-die organizations. The Swiss Academy of Medical Sciences and a National Advisory Commission on Biomedical Ethics have proposed guidelines that seek a more restrictive regulation. In 2009, the federal government finally proposed legislation that would circumscribe the practice of assisted death, but it is not clear whether the Swiss parliament will adopt such a law.

This chapter provides an empirical analysis of suicide tourism. It includes extracts of interviews with key stakeholders in the field of assisted suicide from around Europe. In many countries, there have been legal and public proceedings discussing end-of-life issues (notably assisted suicide), accompanied by varied media coverage of stories of suicide tourism. In some cases, for example Canada, suicide tourism was a social phenomenon that the legislator wanted to prevent while legalizing assisted suicide. In others, especially the UK and Germany, suicide tourism was referred to by opponents or supporters of proposed laws to legalize or criminalize assisted suicide. This chapter reflects on the fact that, despite these proceedings and the many arguments raised by campaigners to change existing prohibitions against assisted suicide in countries of origin, the law in these countries has not changed, and in some cases its position on assisted suicide has become more prohibitive.

This epilogue argues that, as suicide tourism has become more popular and freely discussed in the media and in public policy circles, the coverage is not always presented in a positive light. Since such a practice is being exposed selectively, reference is made to two categories of cases. The first involves ‘celebrities’ or public figures. The second includes unfamiliar ‘ordinary’ people who suffer from grave illnesses or experience exceptional states of affairs. While suicide tourism enjoys increasing publicity and is present in public discourse and policy-making in many Western countries these days, reference to it damages its reputation and underlines a strong message that it is an unjust, expensive, eccentric procedure that has the potential for much exploitation with minimal safeguards to protect the most vulnerable people in society, especially at times and in situations when they need such protection to the full.

This chapter addresses the morality of suicide tourism. There are three general arguments in support of suicide tourism: the argument based on the right to die; the argument based on free movement; and the argument based on humanitarian aid. Suicide tourism provides individuals with freedom and choice in exercising their right to die, which should receive greater weight than is the case under its current moral and legal standing. This chapter looks at how these advantages correspond to peoples' right to free movement which is more secured and valued in a globalized world and can also be supported by a revised—and more courageous—interpretation of the moral duty to provide humanitarian aid to citizens of less permissive states. It concludes that while the justifications for suicide tourism are powerfully convincing, those against it suffer from theoretical problems and, in some cases, cannot necessarily be supported by empirical evidence.

This introductory chapter provides an overview of suicide tourism. Suicide tourism involves travel by a suicidal individual from one jurisdiction to another, in which the individual will be assisted in their suicide by some other person. There are four characteristics of death tourism that explain why people seek such services: first, the procedures may be illegal in their home countries; second, the person seeks to take care of unfinished business either in their personal life or in the business of ending their lives; third, the person seeks a final solution—not a medical fix or a way to prolong or improve the quality of life; or, fourth, they seek the romantic idealism of ‘death with dignity’, where the deathbed is a romantic notion of a death free from pain and suffering. The chapter then analyses the legality of suicide tourism and its moral standing.

This chapter explores some of the major political-philosophical justifications for and against state interference in suicide tourism. These are divided into five main arguments from the perspective of the state in which assisted suicide is illegal: the idea of state sovereignty; global justice and moral particularism; cosmopolitanism and moral universalism; inter-state moral pluralism; and the notion of common ownership. While these arguments do not necessarily rely on the morality of suicide tourism, their overall evaluation reveals that there are prima facie good reasons against state intervention or for the adoption of a neutral view towards permissive countries. The discussion in this chapter concludes that although there are relatively weak justifications for state intervention in suicide tourism, there are strong justifications for non-intervention.

This chapter examines the alternatives that countries of origin and countries where assisted suicide is legal may exercise with regard to suicide tourism. Specifically, it considers whether actions to limit or prohibit travel for assisted suicide or access to it within a person’s home country can be legally valid. On the one hand, legally restricting access to assisted suicide to residents only or to patients who have had a long-standing relationship with prescribing doctors suffers from much criticism and is difficult to justify. On the other hand, from the perspective of countries of origin, it is difficult and inappropriate to apply the doctrine of extraterritorial jurisdiction to the criminality of assisted suicide. The chapter also considers the strength of other suggestions in relation to international law, particularly the idea of ‘soft law’ regulation of the practice.