(CNN) -- The law on assisted suicide in Switzerland isn't clear, according to a paper published in the journal Law, Ethics and Medicine this week. That's why, the authors say, people from other countries are traveling to the state of Zurich for the "sole purpose of committing suicide."

They're called suicide tourists.

Between 2008 and 2012, 611 "tourists" came to Switzerland for assisted suicide, according to the published analysis. They arrived from 31 countries around the world, though the majority were from Germany and the United Kingdom.

"In the UK, at least, 'going to Switzerland' has become a euphemism for (assisted suicide)," the study authors write. "Six right-to-die organizations assist in approximately 600 cases of suicide per year; some 150-200 of which are suicide tourists."

This published paper is the result of a pilot study completed for a larger project on assisted suicide in Switzerland being done by experts at the Institute of Legal Medicine in Zurich.

Of the 611 assisted suicides identified during the four-year study period, just over 58% were women. The patients' ages ranged from 23 to 97, researchers found, but the average age was 69. Close to half of the patients had a neurological disease. Others stated they had cancer, rheumatic disease or cardiovascular disease. Many had more than one condition.

 

'Heartbroken' right-to-die advocate dies

 

The case in support of euthanasia

 

Assisted suicide group on trial

In all but four cases, the assisted suicides were done using sodium pentobarbital. A fatal dose of this drug causes the patient to slip into a deep coma, according to DIGNITAS, a Swiss right-to-die organization that was involved in most of the identified cases.Sodium pentobarbital paralyzes the patient's respiratory system, causing him or her to stop breathing.

The total number of suicide tourism cases dropped from 123 in 2008 to 86 in 2009. But the number of cases doubled between 2009 and 2012, to 172.

Assisted suicide laws around the globe are in flux as countries debate the pros and cons of allowing doctors to help terminally ill patients, or patients in a lot of pain, die.

In Switzerland, the study authors write, there are no rules to regulate under which conditions someone can receive assisted suicide, though medical professional codes allow it in certain circumstances.

In Germany, there is no formal legal language in the criminal code about assisted suicide, but doctors are not ethically allowed to help someone commit suicide -- and can be held criminally responsible for not helping a patient if they witness him or her going unconscious.

In the United Kingdom, Ireland and France, assisted suicide is illegal, though recent cases have been presented to high courts.

"If Switzerland is happy to continue providing the facility then, however intellectually dishonest it may be to allow her to siphon of all our own English pain, fear, angst and debate, is it likely to do less harm overall than introducing any conceivable assisted suicide law into England," medical lawyer Charles Foster wrote in a commentaryaccompanying the new journal study.

An international survey of 12 European countries found the majority of people favor legalizing assisted suicide, according to the study authors. This seems to match opinion in the United States, wherefour states -- Oregon, Washington, Montana and Vermont -- allow assisted suicide.

Opinion: Suicide doesn't set you free

But others have argued that legalizing assisted suicide is not addressing the real issue, which is the need for better palliative care, and that assisted suicide laws would put vulnerable populations at risk.

Alison Twycross of London South Bank University, in an editorialaccompanying the new study, writes that advocates for assisted suicide often have a friend or relative who experienced a long, painful death. "So the issue," she writes,"may be a need to provide good end-of-life care."

"We need to start asking questions such as: Is it appropriate to give antibiotics to a terminally ill patient who develops a chest infection? It is possible that a tendency to carry on with curative treatment even in those clearly dying explains the general public's support for (assisted suicide)."

Twycross cites data from Oregon that suggests regulations put in place when assisted suicide was legalized are not always followed.

"Autonomy is important," she writes. "But it could be that, in matters of life and death, you cannot create freedom for the few without taking away adequate safeguards for the many."

“自殺旅遊”瑞士自2009年以來增加了一倍
由雅克·威爾遜，美國有線電視新聞網
2014年8月20日 - 更新2249 GMT（0649 HKT）
在全球範圍內協助自殺的法律是在不斷變化的國家辯論的優點和允許醫生利弊，以幫助病人死亡。
在全球範圍內協助自殺的法律是在不斷變化的國家辯論的優點和允許醫生利弊，以幫助病人死亡。
新聞提要
“自殺旅遊”描述了旅行到另一個國家的協助自殺的行為
在2008年至2012年，611人前往瑞士自殺
有超過一半是女性，有很多神經系統疾病
（CNN） -在瑞士協助自殺的法律是不明確的，按照造紙雜誌上發表的法律，道德和醫學這個星期。這就是為什麼，作者說，來自其他國家的人前往蘇黎世為國家“自殺的唯一目的。”
他們被稱為自殺的遊客。
在2008年至2012年，611“遊客”來到瑞士協助自殺，根據公佈的分析。他們來自世界各地31個國家抵達，但大部分來自德國和英國。
“在英國，至少，”去瑞士已成為一種委婉的說法（協助自殺），“研究作者寫道。“六從右到模具機構協助約600例，每年自殺的，其中有些150-200是自殺的遊客。”
該發表的論文是完成了在瑞士協助自殺的一個大項目通過專家法醫研究所在蘇黎世正在做一項試驗性研究的結果。
在4年的研究期間發現的611輔助自殺，剛剛超過58％為女性。患者的年齡介於23至97，研究人員發現，但平均年齡為69。接近一半的患者有神經系統疾病。別人說自己罹患癌症，風濕性疾病或心血管疾病。許多有多個條件。
“斷腸”從右到模具模具倡導者 支持安樂死的情況下， 審判協助自殺群
但在所有四種情況分別進行使用戊巴比妥鈉的協助自殺。這種藥物的致命劑量會導致病人陷入深度昏迷，根據人性尊嚴，參與了大部分的確定cases.Sodium戊巴比妥的癱瘓患者的呼吸系統瑞士從右到模具的組織，使他（她）停止了呼吸。
旅遊自殺個案的總數從123在2008年，2009年下降到了86，但2009年和2012年間病例數增加了一倍，至172。
在全球範圍內協助自殺的法律是在不斷變化的國家辯論的利弊，並允許醫生協助絕症患者，或患者很多痛苦的利弊，死亡。
在瑞士，研究作者們寫到，沒有規則，以規範在何種情況下有人可以接受協助自殺，但醫生專業守則允許它在某些情況下。
在德國，有大約協助自殺的刑法沒有正式的法律語言，但醫生沒有道德上不允許，幫助別人自殺 - 而且可以追究刑事責任不幫助病人，如果他們看到他或她會不自覺的。
在英國，愛爾蘭和法國，協助自殺是非法的，但最近的案例已經提交給高等法院。
“如果瑞士樂意繼續提供該設施的話，但理智上不誠實，可能讓她虹吸所有我們自己的英語痛苦，恐懼，焦慮和爭論，是否有可能少做傷害整體比引進任何可能的協助自殺法律到英國，“醫療律師查爾斯·福斯特在一份評論伴隨新雜誌的研究。
12個歐洲國家組成的國際調查發現，多數人贊成法制化輔助自殺，根據該研究的作者。這似乎符合民意，在美國，在四個州 -俄勒岡州，華盛頓州，蒙大拿州和佛蒙特州-允許協助自殺。
觀點：自殺不給你自由
不過也有人認為合法化協助自殺不是解決真正的問題，這是需要更好的姑息治療，以及協助自殺的法律將使弱勢群體處於危險之中。
艾莉森特懷克羅斯倫敦南岸大學，在社論伴隨新的研究中，寫道，倡導協助自殺往往有一個朋友或親戚誰經歷了一個漫長，痛苦的死亡。“所以這個問題，”她寫道，“可能需要提供臨終照顧得很好。”
“我們需要開始問這樣的問題：它是否適當給予抗生素，以臨終病人誰開發誰胸部感染是可能的趨勢進行了根治性治療，即使在那些清楚地死去解釋了廣大市民的支持（協助自殺）。“
特懷克羅斯來自俄勒岡州的建議制定法規時，協助自殺合法化並不總是遵循援引的數據。
“自主性是非常重要的，”她寫道。“但是，這可能是因為，在生命和死亡的問題，你不能為少數不帶走足夠的保障，許多創造的自由。”