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Cyclist Gino Mäder, 26, dies after a high-speed crash in the Swiss Alps

Bill Chappell

Team Bahrain cyclist Gino Mäder of Switzerland died after suffering a terrible crash in the Tour de Suisse. He's seen here at the 2021 Giro d'Italia road race, wearing the blue jersey signifying the best climber. Dario Belingheri/AFP via Getty Images hide caption

Team Bahrain cyclist Gino Mäder of Switzerland died after suffering a terrible crash in the Tour de Suisse. He's seen here at the 2021 Giro d'Italia road race, wearing the blue jersey signifying the best climber.

Swiss cyclist Gino Mäder died Friday, one day after suffering a terrible crash during a mountain descent in stage 5 of the Tour de Suisse. Both Mäder and another racer, Magnus Sheffield of the U.S., were taken to the hospital after they were hurled into a ravine in the Swiss Alps.

Mäder, 26, crashed during the "queen stage" of the race — the label given to a multistage road race's most challenging and grueling days, which usually involve multiple ascents and test even the strongest riders.

A Pro Cyclist Rode An Unofficial, Solo Tour De France And Beat The Pack

After reaching the Albula Pass at a height just under 7,600 feet, Mäder and other riders faced a roughly 10-kilometer descent , racing down to the stage's finish line. In that segment, a motorcycle camera unit following the race leader clocked speeds of around 100 kph (62 mph).

It's not known precisely what led to the crash; TV broadcasts of the race didn't seem to catch the moment that sent the two riders off the road. "The circumstances of the accident are being clarified," race organizers said on Thursday.

After Mäder's death, the Graubünden cantonal police said on Friday that it is investigating the crash, along with the public prosecutor's office. The police issued a call for witnesses to come forward, particularly if they have video evidence.

The crash came in a high-speed portion of the course

During the descent, the two riders "crashed at very high speed," race organizers said. Another rider, Roland Thalmann, described the scene.

"After a long curve, two bikes were lying on the side of the road, which didn't look nice," Thalmann said, according to Cycling News . "When I looked back, I saw that two riders were quite far down."

Paint outlines of what look to be two tire tracks leading off the road at the curve where Swiss rider Gino Mäder fell during a high-speed descent of the fifth stage of the Tour de Suisse. Mäder, 26, died from injuries he sustained when he plunged into a ravine. Arnd Wiegmann/AFP via Getty Images hide caption

Paint outlines of what look to be two tire tracks leading off the road at the curve where Swiss rider Gino Mäder fell during a high-speed descent of the fifth stage of the Tour de Suisse. Mäder, 26, died from injuries he sustained when he plunged into a ravine.

"The race doctor was on the scene of the accident within two minutes," organizers said. Dr. Roland Kretsch found Sheffield, 21, responsive, with a concussion and bruises. Mäder was in far worse condition in a creek, as he "lay motionless in the water," according to organizers.

The medical team was able to resuscitate Mäder, and he was airlifted to a hospital. Kretsch later told SRF that the cyclists were found far below the roadway, and that Mäder had injuries to his head area.

Mäder's death stuns the cycling world

"Our entire team is devastated by this tragic accident, and our thoughts and prayers are with Gino's family and loved ones during this incredibly difficult time," Mäder's cycling squad, Team Bahrain Victorious, said as it announced his death.

"Today and every day, we ride for you, Gino," the team said.

An aerial photo from June 16, 2023, shows the curve where Swiss rider Gino Mäder crashed during a high-speed descent in the Tour de Suisse. Arnd Wiegmann/AFP via Getty Images hide caption

An aerial photo from June 16, 2023, shows the curve where Swiss rider Gino Mäder crashed during a high-speed descent in the Tour de Suisse.

After the tragic news emerged, cyclists rode an extremely shortened sixth stage of the Tour de Swiss as a memorial to Mäder, with organizers saying the peloton, or main pack of cyclists, would ride only the final 20 kilometers of the planned course under "neutralized" conditions, meaning competition is suspended.

At Friday's finish line, a large crowd turned out to applaud Mäder's six teammates as they crossed the finish line together.

🇨🇭 #Tourdesuisse In honour of Gino! @tds #RideAsOne pic.twitter.com/3jX6WD4BFq — Team Bahrain Victorious (@BHRVictorious) June 16, 2023

The new plan followed another last-minute change, after an avalanche blocked Friday's planned route in the mountains.

In 2021, Mäder won the best young cyclist's white jersey at La Vuelta, Spain's 21-stage race. He took fifth place in that race — the same spot he earned earlier this year, in the eight-day Paris-Nice race.

The Tour de Suisse isn't one of road cycling's three "Grand Tour" races, but with eight stages and plenty of high mountains, it's widely seen as a key tune-up for the Tour de France in July.

Race course layout is put under scrutiny

After Thursday's crash, Belgian rider Remco Evenepoel, the reigning world champion, criticized the race course's layout, as he sent his hopes for recovery to riders who crashed.

I hope all the guys that were involved in a crash are okay!! 🙏🏻❤️ I hope that the final of today's stage is food for thought for both cycling organisers as well as ourselves as riders. (1/2) pic.twitter.com/UZm6sRwiez — Remco Evenepoel (@EvenepoelRemco) June 15, 2023

"While a summit finish would have been perfectly possible, it wasn't a good decision to let us finish down this dangerous descent," Evenepoel said . "As riders, we should also think about the risks we take going down a mountain."

Evenepoel posted that message on Thursday, before news of Mäder's death emerged.

In many stage races with famously imposing mountains, organizers place the finish line at the very top of the mountain, or just beyond it.

Tour De France Officials Search For Spectator Who Caused Massive Crash

Thursday's stage included three mountain passes, with the first (Furka) and last (Albula) rated as "Hors Catégorie" — a designation reserved for ultra-steep climbs that are beyond cycling's normal 5-level categorization for mountains.

"We will see the best climbers in action again, but the last kilometers will also require a large dose of courage and honed descent skills," the race's official guide stated . It promised that the closing kilometers, descending from the Albula Pass to the mountain village of La Punt, "will be something to see."

Mäder died exactly 75 years after the only other death in the Tour de Suisse, which came when Richard Depoorter crashed in a dim tunnel and was run over by an escort vehicle in 1948, according to Swiss broadcaster RSF .

Gino Mader: Cyclist, 26, dies after crashing into ravine during Tour de Suisse

Gino Mader's "talent, dedication, and enthusiasm were an inspiration to us all", his team boss Milan Erzen said, adding: "Not only was he an extremely talented cyclist, but a great person off the bike."

Friday 16 June 2023 15:46, UK

A professional cyclist has died after crashing during the Tour de Suisse - as a world champion criticised the decision to "let us finish down this dangerous decent".

Gino Mader, 26, fell down a ravine as he approached the end of Thursday's mountainous fifth stage.

The Swiss rider crashed on a fast downhill road and medical staff performed CPR at the scene before he was airlifted to Chur hospital, where he later died from severe injuries.

"Despite the best efforts of the phenomenal staff", he "couldn't make it through this, his final and biggest challenge", his team Bahrain Victorious said on Friday.

"Our entire team is devastated by this tragic accident, and our thoughts and prayers are with Gino's family and loved ones during this incredibly difficult time."

A second rider, Magnus Sheffield, also crashed at the same spot. The American suffered a concussion and bruises and was treated at a local hospital.

Thursday's route has been criticised by Belgium's world champion Remco Evenepoel, who finished 10th in stage five and is fourth in the overall standings.

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"While a summit finish would have been perfectly possible, it wasn't a good decision to let us finish down this dangerous descent," Evenepoel wrote on Twitter.

"As riders, we should also think about the risks we take going down a mountain."

'Extremely talented cyclist'

Bahrain Victorious's managing director Milan Erzen said: "We are devastated by the loss of our exceptional cyclist, Gino Mader. His talent, dedication, and enthusiasm were an inspiration to us all.

"Not only was he an extremely talented cyclist, but a great person off the bike."

Teams and riders have been reacting to the news of Mader's death.

"I can't believe what I'm reading. Such a sad sad day. Thoughts with everyone who knew and loved Gino," Geraint Thomas, the 2018 Tour de France champion, said on Twitter.

"No words. RIP Gino. My thoughts are with your family and friends," added Ineos Grenadiers racer Michal Kwiatkowski.

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The Tour de Suisse is a preparation race ahead of next month's Tour de France.

Mader's death was announced about 30 minutes before the scheduled start of the sixth stage in the eight-day race. The start was delayed.

Mader won a stage of the 2021 Giro d'Italia, and went on to finish fifth overall that same year at the Vuelta a Espana. Earlier this year, he was fifth at Paris-Nice.

Watch CBS News

Gino Mäder, Swiss cyclist, dies at age 26 after Tour de Suisse crash

June 16, 2023 / 9:45 AM EDT / CBS/AP

Swiss cyclist Gino Mäder died Friday, his team said, a day after crashing and falling down a ravine during a descent at the Tour de Suisse, a preparation race ahead of next month's Tour de France . Mäder, 26, crashed on a fast downhill road approaching the end of the mountainous fifth stage into La Punt.

"Gino lost his battle to recover from the severe injuries he sustained," the Bahrain-Victorious team said in a statement . "... Despite the best efforts of the phenomenal staff at Chur hospital, Gino couldn't make it through this, his final and biggest challenge, and at 11:30 a.m. we said goodbye to one of the shining lights of our team."

Medical staff who reached Mäder found him motionless in water. They performed CPR before he was airlifted to the hospital.

"Our entire team is devastated by this tragic accident, and our thoughts and prayers are with Gino's family and loved ones during this incredibly difficult time," Bahrain-Victorious said.

Mäder's death was announced about 30 minutes before the scheduled start of the sixth stage in the eight-day race. The start was delayed and riders gathered in a silent tribute before the stage was canceled.

Race organizers said the peloton would ride together in tribute to Mäder for the final 30 kilometers (18 miles) of Friday's scheduled route. The race should resume Saturday.

Team manager Milan Erzen said Bahrain-Victorious will race in his honor.

"We are determined to show the spirit and passion Gino displayed, and he will always remain an integral part of our team," Erzen said.

The manager praised the rider, saying his "talent, dedication, and enthusiasm were an inspiration to us all."

"Not only was he an extremely talented cyclist," Erzen said, "but a great person off the bike."

"Devastated by the news," world champion Remco Evenepoel, who is in fourth place in the race standings, wrote on his Twitter account . "My heart and strength is with Gino's family, friends, teammates."

Evenepoel earlier criticized Thursday's stage after finishing the day in 10th place.

"While a summit finish would have been perfectly possible, it wasn't a good decision to let us finish down this dangerous descent," Evenepoel wrote . "As riders, we should also think about the risks we take going down a mountain."

A second rider also crashed at the same spot. Magnus Sheffield of the United States sustained a concussion and bruises and was treated at a local hospital.

In previous incidents, Belgian rider Wouter Weylandt was killed in a crash on a descent at the Giro in May 2011. Another Belgian rider, Antoine Demoitié, died after crashing at the one-day Gent-Wevelgem race in March 2016.

Mäder was one of Switzerland's best young riders. He won a stage at the 2021 Giro d'Italia and placed fifth overall in the Spanish Vuelta that year. He also was fifth in the Paris-Nice stage race in March.

"We are heartbroken," Tour de Suisse organizers said in a statement. "Gino, you've been an excellent rider but even more a wonderful person. Always smiling and making people happy around you."

Mäder was asked on Sunday at the end of the first stage by a reporter what would make him happy at the end of the weeklong race.

"If I'm still healthy and I enjoy my home race, maybe have some success with the team," Mäder said.

• Switzerland

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Cyclist Gino Mäder dies after ravine crash during Tour de Suisse

Topic: Sport

Gino Mäder of Switzerland and Team Bahrain Victorious in the chase group during the 86th Tour de Suisse 2023, Stage 4. ( Getty Images: Dario Belingheri )

Swiss rider Gino Mäder has died after crashing into a ravine on the descent towards the finish line in Thursday's stage five of the Tour de Suisse, his team Bahrain Victorious said on Friday.

Key points:

• The crash took place on the descent towards La Punt where Gino Mäder fell into a ravine
• He was found unresponsive and resuscitated before being air-lifted to the hospital
• Team managing director Milan Erzen said the team would continue the race in honour of Mäder

"Despite the best efforts of the phenomenal staff at Chur hospital, Gino couldn't make it through this, his final and biggest challenge, and at 11:30 am we said goodbye to one of the shining lights of our team," the team said.

Mäder, 26, crashed on the descent towards La Punt and fell into a ravine where he was found unresponsive by the race doctor and resuscitated before being air-lifted to hospital.

A second rider also crashed at the same spot. Magnus Sheffield of the United States sustained a concussion and bruises and was treated at a local hospital.

In a statement, team managing director Milan Erzen said: "We are devastated by the loss of our exceptional cyclist, Gino Mäder. His talent, dedication, and enthusiasm were an inspiration to us all.

"Not only was he an extremely talented cyclist, but a great person off the bike. We extend our deepest condolences to his family and loved ones, and our thoughts are with them during this difficult time."

Mr Erzen said the team would continue in the race in honour of Mäder.

"We are determined to show the spirit and passion Gino displayed, and he will always remain an integral part of our team," he said.

Mäder joined the Bahrain Victorious team in 2021 and won a stage of the Giro d'Italia that year. He also won the young rider classification at the 2021 Vuelta a Espana.

Mäder was asked on Sunday at the race finish by a reporter what would make him happy at the end of the week-long race.

"If I’m still healthy and I enjoy my home race, maybe have some success with the team," Mäder had said.

Team managing director Milan Erzen said the team would continue in the race in honour of Mäder. ( Getty Images: Dario Belingheri  )

A statement from the professional riders' association CPA, read: "Our hearts bleed at this news. Condolences to his family, the team and the many friends who loved him.

"Like all of us. RIP Gino."

Stage five of the Tour de Suisse had raised some eyebrows in the peloton because of its fast descent near the finish.

After the accident, Belgium's world champion Remco Evenepoel said on Twitter: "I hope that the final of today's stage is food for thought for both cycling organisers as well as ourselves as riders. While a summit finish would have been perfectly possible, it wasn't a good decision to let us finish down this dangerous descent."

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Swiss Cyclist Gino Mäder Dies After High-Speed Crash at Tour de Suisse

• Author: Mike McDaniel

Swiss cyclist Gino Mäder died after a high-speed crash that occurred in the Tour de Suisse on Thursday. He was 26 years old. Bahrain Victorious, his cycling team, confirmed Mäder’s death in an official statement .

“On Friday 16th June, following a very serious crash during stage 5 of the Tour de Suisse, Gino lost his battle to recover from the severe injuries he sustained. Our entire team is devastated by this tragic accident, and our thoughts and prayers are with Gino’s family and loved ones during this incredibly difficult time.” 

The crash itself occurred Thursday, when Mäder’s bike collided with Magnus Sheffield, a 21-year-old from the United States. The incident took place during stage 5 of the race on the descent of the Albula Pass, according to the BBC . Mäder fell into a ravine after being thrown from his bike and had to be resuscitated at the scene before being airlifted to a hospital in Chur, Switzerland.

At the time of the crash, both cyclists were traveling in excess of 60 miles per hour according to data from Sheffield’s Strava account, per the New York Post . Sheffield was treated at a local hospital for a concussion and bruising.

Friday’s stage 6 was canceled, according to a report from the BBC, but the riders planned to finish the final 18 miles together in Mäder’s honor.

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Swiss cyclist dies after fall into ravine during Tour de Suisse

Gino Mäder, 26, dies from injuries a day after crashing and falling down a ravine during the Tour de Suisse race.

Swiss cyclist Gino Mäder has died after crashing and falling down a ravine during a descent at the Tour de Suisse, according to his team Bahrain-Victorious.

The 26-year-old Mäder crashed on Thursday on a fast downhill road approaching the end of the mountainous fifth stage into La Punt.

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“Gino lost his battle to recover from the severe injuries he sustained,” the team said in a statement on Friday.

“Despite the best efforts of the phenomenal staff at Chur hospital, Gino couldn’t make it through this, his final and biggest challenge, and at 11:30 a.m. we said goodbye to one of the shining lights of our team.”

Medical staff who reached Mäder found him motionless in water. They performed CPR before he was airlifted to the hospital.

“Our entire team is devastated by this tragic accident, and our thoughts and prayers are with Gino’s family and loved ones during this incredibly difficult time,” Bahrain-Victorious said.

The Tour de Suisse is a preparation race before next month’s Tour de France.

Mäder’s death was announced about 30 minutes before the scheduled start of the sixth stage in the eight-day race. The start was delayed and riders gathered in a silent tribute.

‘Dangerous descent’

The route for Thursday’s stage was later criticised by world champion Remco Evenepoel, who finished 10th and is fourth in the overall standings.

“While a summit finish would have been perfectly possible, it wasn’t a good decision to let us finish down this dangerous descent. As riders, we should also think about the risks we take going down a mountain,” the Belgian cyclist said on his Twitter account.

American rider Magnus Sheffield also fell on the same descent from Albula, during the most difficult stage of the race with multiple climbs.

The Ineos-Grenadiers rider was hospitalised with “bruises and concussion,” organisers said.

Mäder was one of Switzerland’s best young riders. He won a stage at the 2021 Giro d’Italia and placed fifth overall in the Spanish Vuelta that year. He also was fifth in the Paris-Nice stage race in March.

“We are heartbroken,” Tour de Suisse organisers said in a statement. “Gino, you’ve been an excellent rider but even more a wonderful person. Always smiling and making people happy around you.”

Mäder was asked by a reporter on Sunday at the race finish what would make him happy at the end of the week-long race.

“If I’m still healthy and I enjoy my home race, maybe have some success with the team,” Mäder had said.

Team manager Milan Erzen praised the rider, saying his “talent, dedication, and enthusiasm were an inspiration to us all.”

“Not only was he an extremely talented cyclist,” Erzen said, “but a great person off the bike.”

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Three Teams Drop Out of Tour de Suisse After Cyclist’s Death

Gino Mäder’s Bahrain-Victorious squad and two other teams withdrew on Saturday, but organizers said they would complete the multistage race this weekend.

By Andrew Das

The Tour de Suisse cycling race resumed its multistage competition on Saturday, one day after a rider died from the injuries that he sustained in a crash during a high-speed mountain descent.

The rider, Gino Mäder, was a member of the Bahrain-Victorious team, which announced on Saturday morning that it was withdrawing from the race. Two other teams, Tudor Pro and Intermarché-Circus-Wanty , also said they had decided to leave the race.

The Bahrain-Victorious team’s riders, as well as the rest of the competitors, were informed of Mäder’s death on Friday morning — a day after he went off the course and tumbled down a steep ravine. The riders participated in a shortened memorial ride on Friday that replaced the day’s stage, which was called off.

But with the race, an important tuneup for the Tour de France next month, set to return for its final two competitive stages this weekend, Bahrain-Victorious confirmed on social media on Saturday morning that its team would not take part.

“Following the tragic loss of Gino Mäder,” the team said in a post on Twitter, “Team Bahrain Victorious has taken the decision to withdraw from Tour de Suisse.”

Two other teams quickly followed suit. Both cited the well-being of their riders in their decisions to drop out. “Under these difficult circumstances we feel it is the human way to respect the feelings of our riders and pay respect to Gino,” Tudor Pro’s statement said.

Race officials said late Friday that they had made the decision to continue the race in consultation with the family of Mäder, one of Switzerland’s best young riders. A four-stage women’s event began on Saturday as planned.

“After consultation with all the people involved, we as the management stand united behind this decision and are trying to hold the last two stages of the men’s race in an appropriate setting,” the tour’s race director, Olivier Senn, said in a statement.

“Today was the worst day of my life,” Senn added in the statement. “But tomorrow is a new day, and that’s what we have to take care of as an organization.”

The police are investigating the crash, and officials were reported to be interested in hearing from any witnesses who might have seen and filmed the episode.

Mäder crashed along with an American rider, Magnus Sheffield, on Thursday near the end of the fifth stage of the weeklong race, which ends with a final descent down the Albula Pass. The final section where the crash occurred, just after a sweeping downhill curve on an unprotected road with mountains to its left and a steep drop-off just beyond its right edge, was largely empty when the riders passed through it.

Photographs of the area of the crash showed what appeared to be two sets of tire tracks leading to the edge of a sharp drop above the site where Mäder and Sheffield fell.

Mäder and Sheffield were treated where they came to rest, near a set of drainage pipes down a long slope. Sheffield, who was reported to have sustained a concussion and cuts and bruises, appeared to be able to walk back up the hill with assistance. Race officials said Mäder was revived at the scene after being discovered “motionless in the water.” After initial treatment, he was evacuated from the scene in a helicopter.

At least one rider, the reigning world champion Remco Evenepoel, suggested that the course did not have to be so treacherous.

“I hope that the final of today’s stage is food for thought for both cycling organizers as well as ourselves as riders,” Evenepoel said on Twitter after the crash but before the severity of Mäder’s condition was known. “It wasn’t a good decision to let us finish down this dangerous descent. As riders, we should also think about the risks we take going down a mountain.”

Andrew Das joined The Times in 2006. An assistant editor in Sports, he helps direct coverage of soccer, the Olympics and international sports. More about Andrew Das

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VILLARS-SUR-OLLON, SWITZERLAND - MAY 01: Gino Mader of Switzerland and Team Bahrain Victorious takes the pose for a picture after press conference after the 75th Tour De Romandie 2022 - Stage 5 on May 1, 2022 in Villars-sur-Ollon, Switzerland. (Photo by RvS.Media/Basile Barbey/Getty Images,)

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Swiss cyclist Gino Mäder died Friday, one day after crashing and falling down a ravine during a descent at the Tour de Suisse, the Bahrain-Victorious team said.

The 26-year-old Mäder crashed on a fast downhill road approaching the end of the mountainous fifth stage into La Punt.

“Gino lost his battle to recover from the severe injuries he sustained,” the team said in a statement. “Despite the best efforts of the phenomenal staff at Chur hospital, Gino couldn’t make it through this, his final and biggest challenge, and at 11:30 a.m. we said goodbye to one of the shining lights of our team.”

Medical staff who reached Mäder found him motionless in water. They performed CPR before he was airlifted to the hospital.

“Our entire team is devastated by this tragic accident, and our thoughts and prayers are with Gino’s family and loved ones during this incredibly difficult time,” Bahrain-Victorious said.

The Tour de Suisse is a preparation race ahead of next month’s Tour de France.

Mäder’s death was announced about 30 minutes before the scheduled start of the sixth stage in the eight-day race. The start was delayed and riders gathered in a silent tribute.

The route for Thursday’s stage was later criticized by world champion Remco Evenepoel , who finished 10th and is fourth in the overall standings.

“While a summit finish would have been perfectly possible, it wasn’t a good decision to let us finish down this dangerous descent,” Evenepoel wrote on his Twitter account. “As riders, we should also think about the risks we take going down a mountain.”

A second rider also crashed at the same spot. Magnus Sheffield of the United States sustained a concussion and bruises and was treated at a local hospital.

Mäder was one of Switzerland’s best young riders. He won a stage at the 2021 Giro d’Italia and placed fifth overall in the Spanish Vuelta that year after placing 74th in the Olympic road race. He also was fifth in the Paris-Nice stage race in March.

“We are heartbroken,” Tour de Suisse organizers said in a statement. “Gino, you’ve been an excellent rider but even more a wonderful person. Always smiling and making people happy around you.”

Mäder was asked on Sunday at the race finish by a reporter what would make him happy at the end of the week-long race.

“If I’m still healthy and I enjoy my home race, maybe have some success with the team,” Mäder had said.

Team manager Milan Erzen praised the rider, saying his “talent, dedication, and enthusiasm were an inspiration to us all.”

“Not only was he an extremely talented cyclist,” Erzen said, “but a great person off the bike.”

‘Suicide tourism’ and understanding the Swiss model of the right to die

PhD Candidate in Sociology and Pierre Elliott Trudeau Foundation Scholar, Université de Montréal and Université de Lausanne, Université de Montréal

Disclosure statement

Samuel Blouin receives funding from the Pierre Elliott Trudeau Foundation and has received funding from the Vanier Canada scholarship program of the Social Sciences and Humanities Research Council of Canada.

Université de Montréal provides funding as a founding partner of The Conversation CA-FR.

Université de Montréal provides funding as a member of The Conversation CA.

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Two weeks ago, the 104-year-old Australian scientist David Goodall flew from his home in Western Australia to Switzerland to access assisted suicide with the help of lifecircle and Exit International, two right-to-die societies.

Goodall was part of a broader but marginal phenomenon sometimes referred to as “suicide tourism.” This occurs when a person travels to Switzerland in order to access an assisted death, because this is forbidden or access criteria are more restrictive in their home country.

His story made headlines all around the world and fuelled public debates. Yet the media coverage has not promoted a greater understanding of the Swiss model of assistance in dying.

Cases of “suicide tourism” presented in the media typically say little about the functioning of the Swiss model. Instead, the coverage of “suicide tourism” speaks more to the state of the public debate in a given country on assistance in dying.

However, Switzerland is not only the final destination in the journey of a person towards death. It is also the starting point of recurrent public debates in the countries of origin of those foreign nationals seeking an assisted death in Switzerland.

The fact that citizens of one country make the decision to die in another country, far from their home and family, has a powerful effect on the public. It provides convincing evidence of determination and suffering. It also shows that other possibilities for regulating assistance in dying exist.

I have been carrying out research for the last three years comparing Canada and Switzerland, more specifically the province of Québec and the canton de Vaud, Switzerland . While I look at public policies, the main focus of my preliminary findings examine the meanings and experiences of those involved in assisted dying practices.

Medical assistance in dying

Some people undertaking this journey are conscious of the public appeal of their decisions, as shown by the news conference held by Goodall on May 9, 2018, before his death in Basel. Some, like Goodall, participate in a movement of older right-to-die activists advocating for “old age rational suicide.” For others, suffering related to a medical condition is the main motivation.

Switzerland sometimes shows up in the national conversation on assisted dying in Canadian news stories. The most well-known occurrence was the story of Kay Carter , suffering from spinal stenosis, who died in Switzerland with the help of Dignitas, a Swiss right-to-die society.

Assisted dying was not yet legal in Canada. Following years of legal challenges in which Carter was one of the plaintiffs, her name is now attached to the Supreme Court of Canada decision that decriminalized medical assistance in dying (MAiD) in Canada in 2015.

In Québec, the 2004 documentary Manon: Le dernier droit? follows Manon Brunelle, a woman suffering from multiple sclerosis who left Canada to die with Dignitas in Switzerland. This film sparked a public conversation.

The legalisation of MAiD in Canada did not bring an end to so-called “suicide tourism” by Canadians. According to Dignitas’ statistics , 60 Canadians used its service between 1998 and 2017, including 12 in 2017.

Assisted dying as an act of citizenship

Under the radar of international controversies, other Swiss right-to-die societies have developed practices that tend to go unnoticed.

Dignitas, which is only one out of eight Swiss right-to-die societies, garners most of the attention as it is perceived as the most controversial. The founder, Ludwig Minelli, is currently being prosecuted for making a personal profit out of three assisted suicides, which is prohibited by the Swiss Criminal Code . These charges have not yet been proven in court.

In Switzerland, assisted suicide has been tolerated since 1942 provided that the person assisting has no selfish motive. Moreover, the person requesting such assistance must self-administer the lethal drug and must have decision-making capacity.

Compared to the comprehensive Canadian federal and provincial laws on MAiD, Swiss regulation and safeguards can be perceived as lacking. However, this misses the meaning of assisted suicide in Switzerland.

Unlike in Canada, assisted suicide is an act of citizenship in Switzerland, not a health-care intervention. Switzerland proposes a much less medicalized approach to assisted dying.

Swiss guidelines

The Swiss model rests mostly on ethical guidelines drawn up by various health-care organizations and on the rules decided by right-to-die associations .

For example, the nonprofit EXIT association active in the French-speaking region of Switzerland has more than 26,000 members who all have a vote at the annual general meeting. To become a member, a person must pay an annual fee of US$40 (equivalent to 40 Swiss Francs), be over 20 years old and also be a Swiss resident. The association provides assistance in suicide, free of charge, to its members. Nonresidents and minors are thus inadmissible.

Besides the legal requirements, the association has its own criteria according to which volunteers can help a member die. These criteria include :

» Suffering from an incurable disease or from an important invalidity or experiencing intolerable suffering.

» Or suffering from disabling polypathologies related to old age.

A consulting physician assesses whether or not the requester meets the criteria and, if they do, she will prescribe a lethal drug that a volunteer will bring.

Volunteers are not chosen on the basis of their professional qualifications but on their skills as accompanying persons — their capacity to demonstrate compassion and understanding.

After the death, the volunteer calls the police who will investigate the case. The public prosecutor will then decide whether or not criminal charges will be brought against the persons involved.

Dignity at the end of life

In Québec, the Act respecting end-of-life care was adopted in 2014 and entered into force in 2015. Besides creating a right to palliative care and regulating continuous palliative sedation among other things, the law legalized medical aid in dying which includes only euthanasia (administration by a doctor) and not assisted suicide (self-administration). In this context, assisted suicide was ruled out as an appropriate option because it “ does not reflect the values of medical support and safety .”

The federal law legalized medical assistance in dying in 2016 and includes both euthanasia and assisted suicide.

Even though the federal legislation on MAiD allows for both euthanasia (administration by a doctor or nurse practitioner) and assisted suicide (self-administration), Canadians almost exclusively favour the first option.

According to a report published in October 2017 , only five persons out of 2,149 have chosen a self-administered death. Thus, Switzerland might not be a model for Canada.

On the other hand, the comparison that I have been carrying out between Canada and Switzerland shows that assistance in dying can be considered not only as a patient’s but as a person’s decision. Just as there are non-medical options to assist birth, non-medical or less medical ways to assist death could be entertained.

Besides the option of palliative care and other social programs, the Swiss model is an invitation to imagine and consider other societal responses to the challenges of suffering and dignity at the end of life.

• Medical ethics
• Right to die
• Supreme Court of Canada
• Global perspectives
• medical assistance in dying

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In 2008, Debbie Purdy and her lawyer were building a case concerning the prosecution of her husband. She wanted to know whether her spouse, Omar Puente, would be imprisoned if he played any role in her death, but the British Director of Public Prosecutions was being maddeningly unclear on the subject. Finally, in 2009, Parliament’s Law Lords ordered the director to clarify the matter . The change came too late for Purdy, but the guidelines published as a result of her case would provide invaluable information to many other Britons.

Purdy, who had been suffering from progressive multiple sclerosis for almost 20 years, hadn’t been seeking protection from her husband. Quite the contrary — she had been looking for assurance that he would not be prosecuted if he helped her end her life. Multiple sclerosis has no cure, and would put Purdy through an array of terrible symptoms including painful muscle contractions, incontinence, tremors, and paralysis. Her plan had been to travel from her home in England to an assisted-suicide organization in Switzerland, and she wanted to know that Puente would not be punished for taking her. Under British law, those who “aid, abet, counsel, or procure the suicide of another,” face up to 14 years in prison.

Though Purdy’s condition deteriorated during the court proceedings and she never got to make the trip, her case was a landmark in the recent history of suicide tourism. The world’s nations, and even the American states, don’t agree on the legality of assisted suicide. As a result, those living in regions that prohibit the practice are traveling many miles to reach a place where they can die with dignity — and creating ethical and legal complications as they go.

Murky Waters

Euthanasia and assisted suicide have taken place in varying degrees and with questionable legality for centuries . Physician-assisted suicide’s time in the mainstream has been relatively brief, but in a little over a decade the practice has become an intensely debated political and ethical topic.

Helping someone end their life is morally and ethically complicated, and that’s reflected in the vague language of many countries’ laws, which has in turn contributed to confusion and court cases like Purdy’s. Some countries, like the Netherlands, explicitly legalize physician-assisted suicide in situations where certain criteria are fulfilled. Likewise, doctors in five U.S. states are legally permitted to prescribe lethal doses of medicine for patients who intend to end their lives. Belgium, with the world’s most liberal suicide laws, even explicitly permits euthanasia by lethal injection.

The laws of other places are not nearly so clear. In 2015, German lawmakers passed a bill allowing assisted suicide for “altruistic motives” but banning the practice when conducted on a “business” basis. In Switzerland, inciting or assisting suicide for “selfish motives” has been illegal since 1942, implying that doing so is only punishable by law if the helper makes personal gains from the death.

Former German Justice Minister Brigitte Zypries told the Associated Press that the German law “will open an era of great legal uncertainty,” and pointed out that it is unclear when a doctor behaves in “a business fashion.” If Switzerland’s vague law is any indication, however, right-to-die advocates will interpret the law in their favor. Since assisted suicide in non-selfish cases is not clearly regulated, the country has become a hot spot for the practice — not only among terminally ill Swiss citizens, but for anyone around the world hoping to end his life.

Destination Death

As the idea of assisted suicide becomes more acceptable around the world, many patients have grown critical of restrictive laws in their states and countries. For those with a progressive or terminal disease, making the effort of campaigning for change with a local government is unappealing — after all, Purdy grew too weak to travel after fighting her legal battle. Instead of dying by assisted suicide, she ended up in hospice care, intermittently refusing to eat until she passed away. For most patients hoping to end their lives, traveling to a region that allows assisted suicide is much easier than changing the law at home. Thus suicide tourism was born.

The phenomenon has only grown and will continue to do so unabated, according to one team of Swiss researchers. They found that, between 2008 and 2012, 611 visitors came to Switzerland for the sole purpose of ending their lives. These people came from 31 different countries, but most hailed from Germany and the United Kingdom. The study authors write that “in the UK, at least, ‘going to Switzerland’ has become a euphemism for assisted suicide.”

Suicide tourism is not confined to Europe. The widely publicized case of Brittany Maynard , a 29-year-old with terminal brain cancer, brought assisted suicide into the public sphere in the United States, causing an eruption of debate over the right to die and the hassles the current patchwork of state laws produces. Maynard, a resident of California, was forced to uproot her family to go through with her plan to “die with dignity.”

“I met the criteria for death with dignity in Oregon, but establishing residence in the state to make use of the law required a monumental number of changes,” she wrote. “I had to find new physicians, establish residency in Portland, search for a new home, obtain a new driver’s license, change my voter registration, and enlist people to take care of our animals, and my husband, Dan, had to take a leave of absence from his job.”

Maynard noted that most families do not have to resources or flexibility to make such extensive changes.

A Weighty Responsibility

In many cases, it seems countries like Switzerland and states like Oregon are providing a humane service to the terminally ill and their families, one unavailable to them had they stayed home. Some countries want no part of that, however.

Canada , for example, has introduced an assisted suicide law that specifically limits the practice to citizens and residents, excluding foreigners. It can be difficult to understand why a country would withhold medical care, but the tough ethical questions aimed at countries with liberal assisted suicide and euthanasia laws can be hard to handle.

Lawmakers must determine how severe a person’s condition must be before they can legally seek assisted suicide. Most associate the practice with terminal illness, but not all cases concern such an ailment. Comparing their findings to those in two earlier studies, the authors of the Swiss suicide tourism study said their research showed that doctors diagnosed an increasing proportion of neurological and rheumatic diseases among suicide tourists.

“This implies that non-fatal diseases are increasing among the suicide tourists and probably also among Swiss residents,” they wrote.

Liberal euthanasia and assisted suicide laws such as those in Belgium and lack of precise regulation have opened the option to many non-terminal patients. Such laws allow patients with rheumatoid arthritis, osteoporosis, and mental health problems to take their own lives. Nathan Verhelst, a transgender Belgian man, chose to end his life in 2013 after failed sex reassignment surgery, citing psychological suffering. Belgian twins Eddy and Marc Verbessem had been born deaf and were slowly losing their sight as well. They chose to die in January 2013.

Who Has the Right to Dignity?

As assisted suicide becomes more common, an increasing number of cases will test the line between the humane and the unacceptable — a category that usually includes traditional, unassisted suicides. People are at a much higher risk for self-harm when suffering from mental illnesses such as schizophrenia, bipolar disorder, and depression, for example, and the latter commonly afflicts those with serious, chronic illnesses. In an editorial concerning physician-assisted suicide, Dr. Morton Tavel, a clinical professor emeritus at the Indiana University School of Medicine, addressed the fine line doctors walk when navigating the law and individual cases.

“Although such laws are humane and sensible, they can be abused and result in wrongful deaths,” he wrote. “We physicians commonly encounter severely depressed patients without life-threatening physical maladies, who, on their own, might opt to commit suicide. … Obviously, in such cases a caregiver’s assistance in suicide would represent a serious disservice.”

Tavel elaborated for Medical Daily, explaining that most physicians would be able to recognize a depression so severe it is disproportionate to a patient’s physical disease, and that they should ask for a psychiatric evaluation in those cases.

“Treatment for the depression with psychotherapy, combined with drug treatment, may allow a patient to return to a satisfactory and prolonged survival,” he said. “If such an outcome seems possible, then assisting one in suicide would be unwise at best.”

Tavel said a patient’s personal physician is the one most qualified to judge their physical and mental state and to request assisted suicide. Ideally, all local jurisdictions would have laws permitting physician-assisted suicide for this reason, but many do not. Tavel supported the idea of applicants traveling to places with more permissive laws, but on the condition that “medical professionals at the receiving destinations are supplied with sufficiently detailed local analyses of the situations” of the patients. “Only then should they be allowed to proceed with ending life in this fashion,” he concluded.

Like Tavel, Maynard’s widower Dan Diaz supports the right to travel for death with dignity, and has become an advocate for allowing the practice in more states. He told the Cleveland Plain Dealer he hopes to debunk misconceptions about patients seeking the right to die. A person who participates in a medical-aid-in-dying program hasn’t necessarily given up hope, he said, and may not be planning to take his life in the near future. Just having the lethal dose of barbiturates in her possession lessened Brittany’s fear of suffering.

“When you have cancer, you fight,” he said. “Having this medication changed nothing about our ability to fight. The strength of this [right to die] legislation is that it provides the [patient] peace of mind. … Brittany had taken the control back from the tumor.”

The governments and populations of many regions remain opposed to physician-assisted suicide, and will likely remain so for years. Which means suicide tourism is here to stay — regardless of whether it is ethical and responsible.

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