INSIDE DIGNITAS – The path to an accompanied suicide at “DIGNITAS – To live with dignity – To die with dignity” in Switzerland
07 August 2024
Preparing for an accompanied / assisted suicide (AS) is a demanding process for everyone involved, especially if the person who wishes to end their suffering and life is not a Swiss resident.
The following requirements, among others, must be met for an AS in Switzerland:
- the person must be a member of DIGNITAS in Switzerland,
- there must be no signs of a lack of capacity of judgment – not just at the time of the request for accompanied suicide, but until the very end; persons lacking capacity cannot be assisted,
- the person must be able to perform themselves the act that causes their death: ingesting the medication sodium pentobarbital or triggering an intravenous ingestion by pressing the button on the syringe driver. In Switzerland, this act may not be carried out by a third person, as this would be a punishable act of “homicide at the request of the victim” as the law calls it, in other words “voluntary euthanasia”.
The request
The person’s wish for an AS and its motivation and firmness must be sufficiently documented. To initiate the preparations, DIGNITAS requires a written request with:
- a personal letter in which the member clearly explains his / her wish for an AS, and unambiguously asks DIGNITAS to start preparations,
- a life report that also provides information about the family situation,
- current and older medical reports with substantial information on diagnosis(es), (attempted) treatments and measures, medication, development of the illness, maybe prognosis, etc.
DIGNITAS will check the request for completeness and comprehensibility. Depending on the diagnosis and situation, further documents might need to be submitted. All documents, including medical reports etc., must be written in German, English, French or Italian. If this is not the case, the member must have the documents translated by a certified translator.
The “provisional green light”
In Switzerland, only physicians with a licence to practise can issue a prescription for the medication sodium pentobarbital used for an AS. As soon as the documents are complete, together with the request, they are forwarded to a Swiss physician independent of DIGNITAS for a detailed examination. Based on the file / request, the physician decides whether he or she is willing, in principle, to issue a prescription for this DIGNITAS member. Without such consent by a physician no AS takes place. If the physician agrees, DIGNITAS refers to this as “provisional green light”. “Provisional” because at least two personal consultations with the physician must take place before a final decision is made. In complex cases, the documents are submitted to several physicians for assessment.
Important: By experience, the preparation phase up to and including the “provisional green light” takes quite some time; at least three months should be expected. For members living in Switzerland whose treating physician or GP has agreed to issue a prescription, this phase is considerably shorter.
Preparing the AS
If, after receiving the “provisional green light”, the member decides to make use of the AS, he or she contacts DIGNITAS again. In this phase, many details need to be discussed, clarified, decided and organised, such as the place and date of the AS, involvement of family and friends, travel and accommodation.
At this stage, members living abroad must submit various official documents such as a birth certificate newly issued by the place of birth, and proof of residence, which, depending on the country, must be translated and apostilled. If someone is divorced or widowed, the divorce decree or the death certificate of the deceased partner is required. As the documents differ depending on the country of origin and marital status, DIGNITAS will advise the member accordingly. The documents are essential so that the competent Swiss civil registry office can register the death after the AS and issue an internationally valid death certificate. It should also be noted that many of the required documents must not be older than 6 months on the day of the AS.
During this phase, the “afterwards” also needs to be discussed and prepared. This includes, for example, instructions for cremation and despatch or collecting of the urn, or transfer of the body abroad, and special last wishes.
The assisted suicide
The “provisional green light” is a prerequisite for the preparation and realisation of an accompanied suicide but it is not a guarantee. The member’s state of health may change in the course of the preparations, doubts may arise as to the firmness of the wish to die, or a lack of capacity may develop. For this reason, in the days leading up to the AS, at least two personal consultations are held with the doctor who has given the “provisional green light”. DIGNITAS’ employees also check the requirements for AS several times during the preparations. If in doubt, they can – just like the member, of course – call off the AS even at the last moment.
Only if all the requirements for a legal and safe accompanied / assisted suicide are met, does the Swiss physician issue the prescription after the two consultations. This allows DIGNITAS to obtain the medication sodium pentobarbital required for assisted suicide on the agreed day so that the member can end their life in a self-determined and safe manner, professionally accompanied by two DIGNITAS employees, and in the presence of family and friends. For members who are not a resident of Switzerland, AS usually takes place in designated private premises owned by DIGNITAS; for members living in Switzerland, it will take place at their home.
For more information, please refer to our information brochure.
Frequently asked question: What if I suffer from a mental illness?
Persons suffering from a mental illness basically have the same option to apply for an AS as those with a physical illness, if they fulfil all the requirements that apply to the latter. As a special requirement, they must additionally provide an in-depth psychiatric expert report confirming that the wish to die is not the expression of a treatable mental disorder (e.g. an acute life crisis or temporary depression), but the self-determined, well-considered and firm decision of a person capable of judgment on the grounds of a serious, long-term mental illness.
