From a phone call to a recognised human right
03 November 2026
Swiss Federal Supreme Court ruling BGE 133 I 58[1] of 3 November 2006
20 years of the right to decide on the time and manner of one’s own end in life
Prologue
Already before the association ”DIGNITAS – To live with dignity – To die with dignity” (in short “Dignitas”) was founded, Ludwig A. Minelli, a human rights lawyer, held the view that choosing to end one’s own life was a human right. He published various articles on the subject, also referring to legal-academic literature. It was probably only a matter of time before a court would address this issue. And that is exactly what happened.
The phone call
In 2004, a man from the Basel region contacted DIGNITAS and explained that he was suffering from bipolar affective disorder – formerly known as manic depression. He had already made two apparently unsuccessful attempts to end his life, had been admitted as an inpatient to a psychiatric clinic on nine occasions, and now wished to receive DIGNITAS’ support in bringing his suffering to an end.
At that time, due to legal disputes, it was very difficult, if not impossible, to obtain a «green light» from a Swiss doctor for an accompanied suicide (assisted dying) for a patient who was capable of judgement but suffered primarily from a mental illness.
Unsurprisingly, on the man’s request no psychiatrist could be found who was willing to approve of assisted dying for him and prescribe the medication of choice for this purpose – 15 grams of sodium pentobarbital.
DIGNITAS explained the situation to him and, at the same time, asked whether he might be willing to pull through at least for some time and challenge the Swiss legal status quo by requesting the medication directly from the Swiss health authorities and, if that was not accessible, to resort to the courts.
After taking some time to reflect the matter, he said that he would give it a try – with the appropriate legal support, of course.
Precedent court proceedings to access sodium pentobarbital
The man subsequently submitted applications to several authorities, seeking permission to obtain 15 grams of sodium pentobarbital through the association DIGNITAS, without having to present a medical prescription. In each case, he justified his request on the grounds that, as a person with capacity of judgment, he was entitled to end his own life without risk or pain and without endangering third parties.
Not particularly surprising, the Federal Office of Public Health and the Health Directorate of the Canton of Zurich rejected his application. Both authorities took the view that sodium pentobarbital was a substance that could only be dispensed by pharmacies on presentation of a medical prescription. Other authorities, namely the Federal Department of Home Affairs and the Administrative Court of the Canton of Zurich, also ruled against him.
His case was therefore eventually brought before the Swiss Federal Supreme Court.
Not without a medical prescription, …
In its judgment of 3 November 2006, the Swiss Federal Supreme Court held that, under the relevant national and international legislation, sodium pentobarbital could only be dispensed to the appellant on presentation of a medical prescription.
… but a human right, …
However, the Court was the first in Europe to confirm the position outlined above, as held by Minelli and other legal experts: «The right to self-determination within the meaning of article 8 § 1 of the European Convention on Human Rights also includes the right to decide how and when one’s own life should end, at least insofar as the person concerned is capable of freely forming their own will in this respect and acting accordingly.»[2]
… which also applies to people with an underlying mental illness
With regard to the appellant, the Court also established equal treatment: «It cannot be denied that an incurable, permanent and severe mental impairment may, in the same way as a somatic condition, give rise to suffering that makes life seem no longer worth living to the patient in the long term.»[3] This meant that, where the wish to die was based on an autonomous decision that took the overall situation into account, sodium pentobarbital could, under certain circumstances, also be prescribed to individuals with a mental illnesses, thereby enabling them to receive assistance with suicide. This requires a comprehensive expert psychiatric assessment medical report.
Confirmation from Strasbourg
With the favourable Federal Supreme Court judgment in hand, the man contacted 170 psychiatrists in an effort to obtain a psychiatric assessment followed by a prescription for sodium pentobarbital. His efforts were unsuccessful.
He therefore lodged an application against the Federal Supreme Court judgment with the European Court of Human Rights. Although the Court rejected his application, it confirmed that the right of an individual to decide by what means and at what point his or her life will end is protected by the European Convention on Human Rights.
Epilogue
Since the Swiss Federal Supreme Court ruling of 2006, several other courts in Germany, Austria, Canada and elsewhere have, through their judgments, contributed to greater self-determination over the end of one’s own life and to the legal recognition of «the last human right», as Minelli used to call it.
For this freedom of choice to be exercised, professional advice and support that is open-outcome must be available and easily accessible. This ensures that every person can discuss and seek advice from their (general practitioner) doctor and an organisation such as DIGNITAS about their wishes concerning the way in which their suffering and life should come to an end – a matter that encompasses far more than doctor-supported voluntary assisted dying.
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[1] See Court ruling BGE 133 I 58 (in German)
[2] ibid.
[3] ibid.
