Role of non-governmental organisations in physician assisted suicide

BMJ 2007; 334 doi: (Published 08 February 2007) Cite this as: BMJ 2007;334:295
  1. Stephen J Ziegler, assistant professor1,
  2. Georg Bosshard, research associate2
  1. 1School of Public and Environmental Affairs, Indiana University-Purdue University, Fort Wayne, IN 46805-1499, USA
  2. 2Institute of Legal Medicine, University of Zurich, Zurich, Switzerland
  1. Correspondence to: S J Ziegler zieglers{at}
  • Accepted 2 December 2006

Could right to die organisations be part of the solution to the many ethical difficulties doctors face over assisted suicide? Stephen Ziegler and Georg Bosshard examine how two organisations in Switzerland and Oregon help people die

The legalisation of assisted suicide and the extent of doctors' involvement in the practice continue to generate heated debate within the medical, political, and religious communities. Historically, the discussion was strongly influenced by the Dutch model that permitted a doctor actively to hasten the death of a suffering patient.1 By the 1990s, however, an alternative model had emerged—physician assisted suicide. This increases patient control by enabling self administration of drugs and limits the doctors' role to assessment and prescribing while involving non-physicians and non-governmental organisations in the dying process.1 2 3 4 5

Recent attempts to make it legal for UK doctors to help patients die failed.6 Although the legalisation debate is likely to continue in the United Kingdom and elsewhere, a new debate focusing on the use of people other than doctors in assisted death seems to be emerging.4 7 8 Non-governmental organisations occupy a central role in facilitating physician assisted suicide in Switzerland and Oregon (USA) and also help to limit the role of doctors. Despite their importance, little is known about their services, controls, and how they fit into the larger medical system.


Throughout this article we use the phrase “physician assisted suicide” to describe a procedure where a doctor lawfully provides a lethal dose of drugs to a patient for self administration. Although the description of this process as suicide continues to generate controversy in the United States,9 10 physician assisted suicide does not carry the same connotation in the Swiss culture, is often used in the academic literature, and is distinct from active euthanasia. …

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