The issue of assisted suicide is undoubtedly controversial. Though restricted in many countries, it is not clearly regulated in Switzerland, which leads to a convergence of so-called suicide tourists coming to the country in search of assisted suicide, to "die with dignity." Now, a new study reveals that within 4 years, the number of these suicide tourists going to Switzerland has doubled.

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So-called suicide tourists going to Switzerland in search of assisted suicide have doubled in 4 years, according to the latest study.

The study, published in the Journal of Medical Ethics, reveals that Germans and Brits are the main groups going to Switzerland for assisted suicide (AS), and the top reasons include various neurological conditions, such as paralysis, motor neurone disease, Parkinson's and multiple sclerosis.

Dignitas is the main AS organization operating near Zurich and, between its Swiss and German arms, has over 5,500 members in 60 different countries. "To live with dignity - to die with dignity" is the motto of the organization, which is a member of the World Federation of Right-to-Die Societies.

To investigate whether the availability of suicide tourism in Switzerland had influenced legal changes in AS in other countries, as well as who was going to Switzerland for help with committing suicide, the researchers searched databases of the Institute of Legal Medicine in Zurich for details of investigations and post-mortem exams among non-Swiss nationals who had AS between 2008-2012.

In total, there are six right-to-die organizations in Switzerland, and four of them allow individuals from other countries to use their services.

Germans and Brits highest non-resident customers of Swiss AS

After analyzing the 611 cases of individuals not resident in Switzerland who had undertaken AS, the researchers found that they came from 31 different countries. All but four of these individuals had gone to Dignitas, and their ages ranged from 23-97 years old, though the average age was 69.

Additionally, nearly 60% of the individuals seeking AS in Switzerland were women.

Of the countries represented, Germany had the highest number of tourists, at 268, followed by the UK, at 126. France, Italy, the US, Austria, Canada, Spain and Israel were also in the top 10.

Between 2009 and 2012, when the study took place, the researchers found that the number of people coming to Switzerland for AS doubled.

The team notes that nearly all of the deaths were from taking sodium pentobarbital, the medication most commonly used for AS - which can only be prescribed with specific conditions under Swiss law. However, four people inhaled helium, deaths widely publicized as "excruciating," according to the researchers, who say it could be responsible for the decrease of suicide tourists to Switzerland between 2008 and 2009.

Though 1 in 3 people had more than one condition, neurological conditions made up nearly half of all cases, with cancer and rheumatic diseases following.

'Getting another country to do your dirty work'

The researchers conclude their study by writing that the "unique phenomenon of suicide tourism in Switzerland may indeed result in the amendment or supplementary guidelines to existing regulations in foreign countries."

However, in a linked comment to the study, Dr. Charles Foster - of Green Templeton College at the University of Oxford in the UK - says he is not quite convinced about this for the UK, noting that there are two links between suicide tourism and AS policies there:

"The first is the liberalization of public opinion that comes naturally, if irrationally with familiarity. And the second is the slowly growing public acknowledgement that there is something intellectually, if not morally, uncomfortable about getting another country to do your dirty work."

But he adds that these are not reasons to change English law on AS.

The researchers note that there were certain limitations to their study, prompting them to write that their findings "should be interpreted carefully," given that one third of their study group had more than one disease, while previous studies have not mentioned whether only one disease was mentioned for each person.

Additionally, the study only focused on suicide tourists, opting to leave out Swiss residents.

Still, the team says their results "imply that non-fatal diseases or diseases that are not yet end stage [...] are more often becoming the reason for seeking AS."

Earlier in 2014, Medical News Today reported on a study that suggested assisted suicide is more common in women and wealthier individuals.