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Switzerland already allows physician-assisted suicide for terminally ill patients under certain circumstances. The Federal Tribunal’s decision puts mental illnesses on the same level as physical ones.”It must be recognized that an incurable, permanent, serious mental disorder can cause similar suffering as a physical (disorder), making life appear unbearable to the patient in the long term,” the ruling said.

“If the death wish is based on an autonomous decision which takes all circumstances into account, then a mentally ill person can be prescribed sodium-pentobarbital and thereby assisted in suicide,” it added.

Various organizations exist in Switzerland to help people who want to commit suicide, and assisting someone to die is not punishable under Swiss law as long as there is no “selfish motivation” for doing so.

The judges made clear in their ruling that certain conditions would have to be met before a mentally ill person’s request for suicide assistance could be considered justified.

“A distinction has to be made between a death wish which is an expression of a curable, psychiatric disorder and which requires treatment, and (a death wish) which is based on a person of sound judgment’s own well-considered and permanent decision, which must be respected,” they said.

The case was brought by a 53-year old man with serious bipolar affective disorder who asked the tribunal to allow him to acquire a lethal dose of pentobarbital without a doctor’s prescription.

The tribunal ruled against his request, confirming the need for a thorough medical assessment of the patient’s condition.

Whether any Swiss physician would be prepared to prescribe a lethal dose of pentobarbital to a mentally ill person remains unclear. The country’s national ethics commission could not be reached for comment late on Friday.

Switzerland is one of a number of countries in Europe that allow assistance to terminally ill people who wish to die.

Netherlands legalized euthanasia in 2001 and Belgium in 2002, while Britain and France allow terminally ill people to refuse treatment in favor of death.