In Gross v Switzerland, the European Court
of Human Rights has once again dealt with an application alleging that article 8 ECHR implied a right to an assisted suicide.
The question, whether the right to
private life also embraces the right of an individual to end one’s own life has
already been brought before the Court before. In Pretty v UK, the applicant was
a woman suffering from a terminal disease. At the final stage, this disease was
to paralyze muscles of her breathing system, causing her to die of asphyxiation.
Since she considered this a painful and undignified death, she sought to put an
end to her life. Being physically unable to do so, she had requested an
undertaking from the prosecution service that her husband was not going to be
criminally prosecuted for assisting her to commit suicide. The prosecution
service refused to give the desired undertaking.
The applicant claimed that the
right to private life under article 8 ECHR encompassed a right to end one’s
life and that the refusal of the British authorities to give the requested
undertaking violated amounted to a violation of this right. The Court pointed
out that autonomy is an underlying concept of article 8. It was not prepared to
rule out that the fact, that the British legal framework made it impossible for
the applicant to end her life constituted an interference with the right to
private life. Yet it held that the interference was justified pursuant to
article 8 paragraph 2. The legal provisions prohibiting assisted suicide sought
to protect the interests of weak or vulnerable persons, which was necessary to
safeguard the supremely important right to life. Therefore the Court did not
find a violation of article 8 ECHR.
In Haas v Switzerland, the ECtHR did not
find a violation of article 8 ECHR either. The applicant had been suffering
from a psychiatric disease for more than 20 years. He wished to end his life. To this end, he
requested to be provided with a lethal dose of sodium pentobarbital, which
would ensure a death without suffering. In Switzerland, this substance is (in
accordance with international agreements Switzerland is party to) available
only upon prescription. The applicant had been unable to obtain a prescription
and complained that the regulation preventing him from procuring sodium
pentobarbital infringed on his right to private life under article 8 ECHR.
The European Court of Human Rights
distinguished the case from Pretty v UK. It stated that, other than the
applicant in Pretty v UK, the applicant did not suffer from a terminal disease.
Also, he did not ask for an assisted suicide without criminal prosecution of
the assisting persons. Rather, he alleged that Switzerland was under an
obligation to provide him with a lethal dose of the requested substance. The Court rejected this argument. It referred
to Switzerland’s obligation to make sodium pentobarbital available only upon
prescription. Also, it pointed out that there was no consensus among Council of
Europe member states to the effect that states were to facilitate suicides.
Considering the margin of appreciation which contracting states of the ECHR
enjoyed, the Court did not find Switzerland in violation of article 8 ECHR.
The case of Gross v Switzerland concerned a
similar request. The applicant was born in 1931; while she did not suffer from
any terminal disease, her state of health had deteriorated over the years and
she had become increasingly frail. She was unable to take long walks and every
change of environment frightened her. Since she felt that her life had become more
and more monotonous and distressful over the years, she had developed a strong
wish to die. Following a suicide attempt she had undergone psychiatric
treatment, which had not changed her wish to put an end to her life, though.
She was in possession of an expert statement by a psychiatrist confirming that
she was fully able to form her own judgment.
She requested from several medical
practitioners to be provided with a lethal dose of sodium pentobarbital, which
would enable her to commit suicide in a painless fashion. The medical doctors
she approached declined her request for ethical reasons or for fear of criminal
prosecution.
Having been turned down by private
practitioners, the applicant applied to the health board, a Swiss public entity
concerned with health issues, and asked to be provided with sodium
pentobarbital. Her request was rejected.
She challenged this decision before Swiss courts.
The Federal Supreme Court of Switzerland
held in last instance that the refusal to make sodium pentobarbital available to the applicant was lawful. It
referred to the judgment the European Court of Human Rights had rendered in Pretty
v UK and pointed out that article 8 ECHR did not entail a positive obligation
for states to enable citizens to commit suicide. The Swiss Federal Supreme Court underlined
that the requirement of a prescription to obtain sodium pentobarbital was necessary, because it prevented individuals from hasty and not well
thought-through decisions.
The applicant contended that denying her
sodium pentobarbital, which prevented her from committing suicide and a
painless and reliable manner, infringed upon her right to private life under
article 8 ECHR.
Under Swiss law, assisting in a suicide or inciting
to suicide is a criminal offence only if it performed for selfish reasons.
According to the case law of the Swiss
Federal Supreme Court, medical
doctors are not prosecuted or held criminally responsible for procuring sodium
pentobarbital if they observe certain conditions. The Federal Supreme Court
infers these conditions from guidelines issued by an NGO. These guidelines
state that doctors may issue a prescription for sodium pentobarbital for
patients suffering from a disease which will, according to experience, lead to
death
The European Court of Human Rights
scrutinized her request from the perspective of positive obligations arising
from article 8. It underlined that the
right to autonomy and self-determination was an underlying principle of the
right to private life under article 8 ECHR.
It pointed out that the Swiss Federal
Supreme Court referred in its jurisdictions to guidelines which had been
produce by non-state actors and did not have the quality of a law. It also
stated, that these guidelines established a requirement for the prescription of
sodium pentobarbital which was not reflected in Swiss law, namely the requirement
that patients have a terminal disease. The Court concluded that this was an
element of uncertainty, which might well deter medical doctors from issuing
prescriptions for sodium pentobarbital;
two doctors had refused to issue the prescription.
The uncertain situation as to the
conditions subject to which medical doctors could issue prescriptions was,
according to the Court, likely to cause anguish and insecurity for citizens
considering to put an end to her life.
Therefore, the Court found that Switzerland had violated its positive
obligation to provide clear guidelines for issuing prescriptions for sodium
pentobarbital; it found a violation of article 8.
Anyway, the Court did not rule that the
right to private life entails a right to an assisted suicide.