A university hospital in Switzerland became the first in Europe to allow assisted suicide on Sunday. The university of Lausanne said it would allow patients from New Year's Day to kill themselves on its wards, provided they were incurably ill and of sound mind.

The decision is likely to reopen the already heated but inconclusive debate across Europe about how far doctors and hospitals can go in helping those who are determined to end their lives.

Assisted suicide is already legal in Switzerland, though euthanasia is not. In recent years, dozens of patients some of them British have travelled to Zurich to die with the help of Dignitas and Exit, two organizations that assist in suicide.

Until now hospitals across Switzerland had refused to allow assisted suicide on site and had denied access to the voluntary euthanasia society, Exit.

That decision has now been overturned after an "agonizing" two-year debate, the hospital's legal and ethical director, Alberto Crespo said. "We consulted with priests, nurses, doctors and our own clinical committee. It is a disturbing situation we have been examining," he said.

"We are not trying to encourage suicide. But at the same time, as a hospital, we have to respect the wishes of someone who wants to die.

"We cannot be paternalistic. We cannot decide for a person what they should do. It is up to the person to decide whether they want to live or not."

None of the hospital's staff at the 800-bed hospital, Switzerland's third-largest teaching institution, would be directly involved. "We expect this to be extremely rare," he said.

Patients' wishes

The hospital apparently reached its conclusion after a patient who had already fixed a date to end his own life was injured in an accident and required hospital treatment, staff said.

He refused to be treated, pointing out that he was due to die five days later anyway. He was then too ill to go home to keep the appointment.

The university hospital on Sunday made clear that it will not accept patients who fly from Britain to end their own lives.

"We know that people from England have been going to Zurich. But we won't be using this logic," Crespo said. "We will not accept persons who want to come to the hospital just to commit suicide."

The university's move means that Britain's current legislation on assisted death is now even further out of step with reforms that have happened in several European countries, as well as Switzerland, which has the most liberal laws.

While assisting suicide against someone's wishes is a criminal offence, under article 115 of the Swiss code it is permissible if the person wants to die. In Britain helping someone to commit suicide is punishable with up to 14 years in prison.

The Swiss Medical Association and the National Committee on Ethics have both backed the university's stand. Both say that to respect the wishes and independence of patients assisted suicide should be permitted in exceptional cases, but it should never become a routine procedure.

Dignitas director Ludwig Minelli said in May that his Zurich-based organization had helped at least 450 Europeans, including 30 Britons, since it was founded in 1998.

But it has been investigated on several occasions, and has had to start videotaping the deaths of patients to provide evidence in the event of legal action.

British doctors have traditionally been vocal opponents of assisted suicide, but in June, the British Medical Association dropped its opposition while maintaining its rejection of euthanasia.

Assisted suicide differs from euthanasia in that doctors do not directly administer the fatal dose of drugs, but instead give patients the means to do it themselves.

(China Daily 12/20/2005 page6)