The number of foreigners traveling to Switzerland to commit assisted suicide doubled over a four-year period, a study published in the Journal of Medical Ethics says. In 2012, 172 foreigners took their lives in Switzerland, which has liberal euthanasia rules, up from 86 in 2009. An analysis of the 611 cases between 2008 and 2012 found people from 31 countries were helped to die in Switzerland during the period. The median age was 69. Nearly half came from Germany, while 20 per cent were British. Other countries in the top 10 included France and Italy, which both saw particularly steep rises. The rise in suicides has provoked heated debate in the country. In 2011, voters in the canton of Zurich rejected proposed bans on assisted suicide and “suicide tourism”. A year later, the national parliament voted against tightening controls on the practice. Assisted suicide has been legal in Switzerland since the 1940s, if performed by someone with no direct interest in the death.