Principles / Philosophy

From a philosophical and political perspective, the fundamental values of DIGNITAS are based on values that the Swiss state has upheld since the founding, in 1848 of the modern federation, and the further development of these values on a national and international level since then.

The starting point must be the liberal position that in a free state any freedom is available to a private individual provided that the availing of that freedom in no way harms public interests or the legitimate interests of a third party. These values are:

  • Respect for the freedom and autonomy of the individual as an enlightened citizen
  • Defending this freedom and autonomy against third parties who try to restrict those rights for some reason, whether ideological, religious or political
  • Humanity which seeks to prevent or alleviate inhumane suffering when possible: probably the most shining example of this in our history, on a national and international level, led to the founding of the Red Cross
  • Solidarity with weaker individuals, in particular in the struggle against conflicting material interests of third parties
  • Defending pluralism as a guarantee for the continuous development of society based on the free competition of ideas
  • Upholding the principle of democracy, in conjunction with the guarantee of the constant development of fundamental rights

1) Respect for the freedom of individuals

Respect for the freedom of individuals in the form of an enlightened citizen who takes on personal responsibility (a «citoyen» in the sense of the political philosopher from Basel, ARNOLD KÜNZLI, who died in 2008; in his essay «Bourgeois und Citoyen: Das Doppelgesicht unserer Gesellschaft», in: Michael Haller, Max Jäggi, Roger Müller (Ed.), Eine deformierte Gesellschaft, Die Schweizer und ihre Massenmedien, Basel 1981, p. 299 ff.) he also reveals, among other things, that – in contrast to earlier law – constructive law valid today no longer punishes a suicide attempt.

What Gertrud, the wife of Werner Stauffacher in Schiller’s magnificent epic tale of freedom «William Tell», considered to be freedom – «A leap from this bridge will make me free!» – is most assuredly applicable to every Swiss resident today.

2) Freedom from the expectations of a third party

It is also clear that every person on Swiss soil is entitled to the freedom to live his or her life independent from the individual ideological, religious or other types of ideas of a third party.

No one has the right to impose or even attempt to impose his or her individual ideological, religious or political beliefs on another. Muslims should not do it to Christians, Jews or Buddhists. Christians should not do it to Jews or those of other beliefs and a believer should not do it to an unbeliever – not even using the indirect method of a governmental regulation.

In this case, the state should be the guarantor for a pluralistic society and must forbid anything that would restrict this pluralism or lead it in a certain direction in the interest of a specific ideological viewpoint.

3) Humanity

When addressing the question of whether a person who wishes to die should be offered help, humanity needs to be the central focus.

The term «humanity» is admittedly vague in and of itself; however, it plays an important role for example in the «Declaration of Geneva», which was adopted by the General Assembly of the World Medical Association in 1948 and last amended in 2006.

Although this declaration does not make any reference to medically assisted suicide, it does begin with the formulation:

«I solemnly pledge to consecrate my life to the service of humanity»

The declaration also contains the following as its final sentences:

«I will maintain the utmost respect for human life; I will not use my medical knowledge to violate human rights and civil liberties, even under threat».

Since experience shows, however, that it is difficult to interpret the undefined terms of humanity, respect or even dignity as such, in the end the only help comes from the decision to stop and consider what is the true objective of medicine instead of relying on interpretation.

The German medical ethicist EDGAR DAHL from the Giessen Clinic for­mulates it this way (in his essay «Im Schatten des Hippokrates / As­sis­tier­ter Suizid und ärztliches Ethos müssen sich nicht wider­spre­chen», published in «Humanes Leben – Humanes Sterben», 4/2008, p. 66-67):

«Medicine consists first and foremost of prevention, diagnosis and therapy. This means that it strives to avoid disease, identify disease and treat disease. One could conclude from this that the objective of medicine is to maintain the health of the individual. In fact, the Declaration of Geneva states that «The health of my patient will be my first con­sid­er­a­tion». As enlightening as this declaration appears to be, it is however incomplete. A look at palliative medicine is sufficient to show that a doctor’s duty is not at all limited to simply maintaining health. For example, palliative doctors spend their days and nights caring for patients whose health cannot be restored.

Based on this, it would seem more suitable to consider the objective of medicine to be the alleviation of human suffering. Looking at it this way, we would also be encouraged by asking ourselves why medicine is com­mit­ted to avoiding, identifying, and treating disease. The fight against disease is not an objective in itself. Rather, this fight is taken up to protect us from physical and emotional suffering, which tends to accompany illnesses.

By fulfilling its objective to alleviate human suffering, medicine is how­ever continually bound to respecting the self-determination of human beings. No one is allowed to treat a patient against his or her will. That doctors are only permitted to introduce or terminate medical procedures with the express permission of the patient is now a generally accepted fact. For example, whether or not a life-prolonging procedure is intro­duced or terminated is always and exclusively dependent on the agree­ment of the patient involved.

When medical ethics, as described above, are based on the alleviation of suffering and the respect of self-determination, it should be obvious that these ethics are completely compatible with assisted suicide, since a doctor who fulfils the request of a terminally-ill patient to stop all further therapy and prescribe a lethal medication is alleviating suffering and respecting self-determination.»

A policy that is aimed at doing everything possible to prevent every suicide without taking into account the will of the person concerned violates hu­man­i­ty. Whoever acts in this way to force people to attempt to bring about their own death in a violent manner, and thus accept the possibility of inhumane risks, is acting inhumanely.

Is it somehow humane to allow a person to achieve his or her own will by attempting something such as that reported by an interested person from England who e-mailed DIGNITAS in 2008, and to accept the consequences thereof?

«Dear DIGNITAS.

My name is J.(xx) H.(xx). I am 19 years old, and live in Scotland, UK.

About 2 months ago I attempted to commit suicide by jumping off a multi storey car park. My attempt failed, and instead of dying, I write this e-mail to you from my hospital bed.

I crushed both of my feet, broke my leg, broke my knee, broke my sacrum (part of my pelvis) and most devastatingly, broke my spine, in 3 places, which has resulted in a degree of paralysis in my legs. I spent 6 weeks in hospital in my home town of Edinburgh, and was then transferred to a special spinal rehabilitation hospital in Glasgow.

I am told that I will need to spend 6 months at this hospital, and that I will be in a wheelchair for the rest of my life. I now have a loss of sexual function, which seems unlikely to return, as well as huge problems managing my bowels and bladder (I cannot feel them moving).

I was already suicidal, and now that I will be disabled for the rest of my life, at such a young age, I truly cannot bear the prospect of life. I am only 19, and I now have the grim reality of 60 years in a wheelchair. The physical pain I am in alternates between bearable and completely unbearable. Perhaps the pain will ease off with time, but this is not a certainty. There are times every day where I scream with pain, due to being moved in bed, hoisted into the wheelchair etc.

I would like to ask if I could be considered for an assisted suicide, as I am completely certain I would like to end my life, and believe I should have the right to do so.

I would be too afraid to try and kill myself again, given the devastating effects of my first failed attempt. It would also be much more difficult to attempt suicide from a wheelchair. I only wish that my country was humane enough to let a person die.

Please consider my letter, I hope to hear a response,

J(xx) H.(xx)»

In this message, which must horrify every person who has any feelings what­so­ever, the author has not yet shared what the problem was that motivated him to attempt suicide in the first place.

However, one thing is certain: If, after becoming suicidal, he had had the opportunity to talk with other people about his problem without having to fear that he would be immediately admitted to a psychiatric ward, his fate would have most certainly been different. People would have tried to show him that there were also solutions other than suicide for his problem in order to give him a real chance to solve the underlying problem without resorting to violence against himself. This way, he would not have had to accept the risks that have now marred him in such a devastating way. Under humane con­di­tions of this kind, he would have certainly had a real chance to overcome his suicidal tendencies.

In this context, it is especially important to ask why it is ethically com­mend­able to put a severely suffering animal to death, but it is impossible to allow a severely suffering human to end his or her own life, without having to accept the inconceivable risks of failure and additional self-mutilation. What ab­struse ideas could lead someone to declare that what is humane for a person to do to a suffering animal is unethical if done to a suffering human, especially since an animal cannot express itself in human speech, yet a human can clearly state his or her will?

4) Solidarity for the interests of those who are weaker

Solidarity with, and protecting the interests of, people who are considered weaker, especially in the struggle against the conflicting – and often financially motivated – interests of third parties, is one of the fundamental qualities of the Swiss public spirit.

The principle «One for all and all for one» is not fully realised in the narrow limitations of that which the state directly encourages as solidarity based on the laws it creates, but rather it is only fully realised in the broader field of social solidarity in civil society, that is, turning a certain group of people towards another group that is in need of special help.

5) Plurality

The defence of a pluralistic system is equally important because it alone guar-

antees that the free competition of ideas, and thereby the further development of society, remain possible.

6) Democracy and basic rights

Further significant fundamentals of our shared existence include the principles of democracy within that sphere which is not left up to the individual’s own discretion as a consequence of his or her basic rights.

In this context, it must be said that a representative survey on the topic of assisted suicide found that 75% of the evangelical population and 72% of the Roman-Catholic population would claim the possibility of assisted suicide for themselves and thus endorsed it (in «Reformiert.» 29 August 2008; GALLUP TELEOmnibus survey from 3-12 July 2008 through ISOPUBLIC, Schwerzenbach, published online (PDF-file, in German).

7) Citizens are not the property of the state

Finally it must also be said that people who inhabit a country should never be degraded by being considered the property of the state. They are the bearers of human dignity, and this is characterised most strongly when a person decides his or her own fate. It is therefore unacceptable for a state or its individual authorities or courts to choose the fate of its citizens.

 

Philosophical and political principles guiding the activities of DIGNITAS for download as a pdf-file, see page 22 in the booklet “How DIGNITAS works

 

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