Information brochure
Below, you will find the contents of the information brochure. It is also available as a PDF for download. Please read it carefully.
Overview
Aims and Purpose of Dignitas
The Dignitas Advance Directive / Patient’s Instructions
Legal Accompanied Suicide (Voluntary Assisted Dying) with Dignitas
The Legal Basis
The People behind Dignitas
The Membership of Dignitas
Preparing an Accompanied Suicide
Documentation for the Request
The Provisional Green Light
Preparation for an Accompanied Suicide for People residing in Switzerland
Planning the Accompanied Suicide
The Course of the Accompanied Suicide
Attendance of Next of Kin and Friends
Dignitas has long-standing Experience
Challenges
A Word on Religious Questions
Information on the costs associated with an accompanied suicide with Dignitas
Aims and Purpose of DIGNITAS
The association “DIGNITAS – To live with dignity – To die with dignity” (in short: “DIGNITAS”) was founded on 17 May 1998 at Forch (near Zurich). The organisation, which pursues no commercial interests whatsoever, has, in accordance with its statutes, the objective of securing a life and a death with dignity for its members and of allowing other people to benefit from these values. DIGNITAS pursues this objective by providing its members in word and deed, within the limits of the possibilities available to the association and as appropriate in the individual case.
In accordance with this objective, the activities of DIGNITAS include, amongst others:
• advisory work in regard to all end-of-life-issues
• cooperation with doctors, clinics and other organisations
• enforcement of Patient’s Instructions (Advance Directives) and patients’ rights
• suicide and suicide-attempt prevention
• support in conflicts with authorities, with the management of residential and care homes, and with doctors who have not been freely chosen
• further legal developments in regard to questions about “the last issues”
• physician-supported accompanied suicide (voluntary assisted dying)
For a one-off joining fee of Swiss Francs (CHF) 220 and an annual membership subscription of at least CHF 80 (the amount is at each individual member’s discretion), members gain access to the services of DIGNITAS. In addition, members support the association in its commitment to safeguard human dignity and human rights in life and in death.
DIGNITAS invests any accounting surpluses in the enhancement of its services, in particular in advisory work, further international legal developments, and suicide-attempt prevention.
The DIGNITAS Advance Directive / Patient’s Instructions
Many people do not wish to be kept alive artificially in a hopeless condition. They wish to avoid pointless operations and treatments. They would rather give more life to their years than more years to their life.
A legally enforceable Advance Directive / Patient’s Instructions offers protection and assistance in such situations. It expresses a person’s will at a time when they are no longer able to voice it themselves.
This requires, on the one hand, a binding, unambiguous text drafted by experts. On the other hand, it requires an organisation such as DIGNITAS, which can ensure that the Advance Directive is carried out – even, if necessary, in the face of resistance.
For the duration of their membership, DIGNITAS provides members with an Advance Directive that is legally valid in Switzerland and must be respected by doctors and nursing staff. If necessary, DIGNITAS can support its members in enforcing their Advance Directive, for example by engaging a lawyer.
Because Patient’s Instructions / Advance Directive are closely linked to the law of the country in which they are issued, this service can, in principle, only be guaranteed for the territory of Switzerland.
Legal Accompanied Suicide (Voluntary Assisted Dying) with DIGNITAS
Within the framework of Swiss law, DIGNITAS can enable an accompanied suicide for its members.
DIGNITAS has many years of experience. Together with doctors, our trained staff establish whether the conditions to be observed for an accompanied suicide are met and whether the wish to die corresponds to the declared will of the member. It is particularly important to establish that the member’s capacity of judgement is in no way impaired, and to establish whether or not the member may have been coerced into an accompanied suicide, for whatever reason, by anyone close to them or by third parties.
DIGNITAS procures the lethal medication required for the accompanied suicide, a fast-acting barbiturate.
Every permitted use of such a medication requires a prescription from a Swiss doctor. Anyone resident in Switzerland should first ask their own doctor whether they are willing to issue the prescription. Nowadays, family doctors are often prepared to do so.
Otherwise, or for people who are not resident in Switzerland, DIGNITAS can call on a network of independent Swiss doctors. After a preliminary review of a written request and personal meetings between a doctor and the member, the doctor may issue the prescription to DIGNITAS, once satisfied that the conditions for the requested accompanied suicide are met. Two members of DIGNITAS staff are always present during such an accompaniment.
For DIGNITAS it is important that people who “wish to go” involve their family and those close to them in the preparations at an early stage. DIGNITAS founder Ludwig A. Minelli (1932–2025) used to say: “One should not set upon a long journey without careful preparation, and one should not set upon such journey without having appropriately said goodbye to loved ones.”
Experience shows that only a small proportion of our members ever make use of the service for an accompanied suicide. Knowing that the possibility exists gives them the security of being able to say, in the event of hopeless, prolonged suffering: “I have had enough now: I want to be able to die.” This feeling is something of extraordinary importance for mature individuals.
The Legal Basis
Article 115 of the Swiss Criminal Code (StGB) states:
“Any person who for selfish motives incites or assists another to commit or attempt to commit suicide shall, if that other person thereafter commits or attempts to commit suicide, be liable to a custodial sentence not exceeding five years or to a monetary penalty.”
This means: anyone who, without selfish motives, assists with suicide acts lawfully. The person concerned must have capacity of judgement and be able to carry out the act that brings about death themselves.
The People behind DIGNITAS
DIGNITAS was founded by attorney-at-law Ludwig A. Minelli (1932–2025). DIGNITAS’ structures of association and organisation have been deliberately chosen so that work can be performed efficiently and without conflict, and so that all energies can be invested in the service of the members.
At DIGNITAS, the Board, together with the Secretary-General, ensures that the association’s operational activities function in accordance with its statutes. An Advisory Committee sits alongside the Board for expert questions.
A team of dedicated and experienced staff is available for advisory work, and for all questions relating to membership, Patient’s Instructions, accompanied suicide, etc.
DIGNITAS ensures appropriate further education as well as the training of new team members. DIGNITAS attaches great importance to providing its members with contacts for whom humanity means a great deal.
The Membership of DIGNITAS
A small group of active members forms the General Assembly and thus the basis of the association. They pass the statutes and set the aims which DIGNITAS pursues. They oversee that these aims are realised.
In principle, any adult with capacity of judgement may become a member of DIGNITAS, regardless of place of residence or nationality. However, for legal reasons, DIGNITAS can only provide its members with support in enforcing Patient’s Instructions and with accompanied suicide on Swiss territory.
Within the scope of the law and the possibilities available to DIGNITAS, members are entitled to Patient’s Instructions that are legally valid in Switzerland, as well as to an accompanied suicide in Switzerland. In addition, they are entitled to advice on matters concerning their human dignity in life and at the end of life.
To join Dignitas, please complete the declaration of membership and make the required payment.
One-off joining fee:
Swiss Francs (CHF) 220
Minimum annual membership fee:
Swiss Francs (CHF) 80
Preparing an Accompanied Suicide
In order to be able to make use of the option of a physician-supported accompanied suicide (voluntary assisted dying), a person must:
• be a member of DIGNITAS
• be capable of judgement up to the time of the accompanied suicide
• have a minimum level of physical mobility
• be able to travel to Switzerland
Preparing for an accompanied suicide is a step-by-step process which takes some time. After each step, questions about how to proceed further are answered and details are discussed. A basic prerequisite is that members engage with this process and take responsibility for it. The wish to die must be based on persistent and unbearable suffering. Unbearable suffering may arise, for example, as a result of:
• a serious illness
• an intolerable impairment
• uncontrollable pain
• a long-lasting and/or recurring mental illness
The wish to die must be deliberate and persistent. This means that the members concerned will have grappled with their suffering and engaged with options for alleviating it.
Once these prerequisites are met, a formal written request for an accompanied suicide, with documentation as described hereinafter, may be sent to DIGNITAS as a first step. This request may also be submitted together with the declaration of membership.
Experience shows that a preparation period of several months must be expected. The duration of this phase depends largely on how quickly the required documents are provided in the necessary quality.
Every situation of suffering is different. Depending on the nature of the illness and its symptoms, it may become apparent in the course of the process that further clarification and documents are necessary, thereby extending the processing time.
Documentation for the Request
A request consists of the following three parts:
- A dated and signed letter (preferably typewritten), in which the member concerned describes their wish to die, explicitly requests DIGNITAS to prepare an accompanied suicide, and addresses the following questions:
• How is the current situation experienced, and what limitations exist in everyday life?
• Are there still options, in view of the course and prognosis of the suffering? Can the member concerned envisage making use of them? If not, why not?
• What alternatives to an accompanied suicide are known, and why is an accompanied suicide preferred? - A separate, detailed account of the member’s life. This should not only relate to the history of their suffering, but should also give an insight into how the member concerned has shaped their life to date. In particular, it should provide information on the following aspects of life:
• childhood, schooldays
• education, working life
• family
• other important events in life
• the current living situation
• the degree of independence
• family and other social contacts
• who is aware of and supports, or opposes, the wish to die
• who would accompany the member concerned to Switzerland. - Medical reports from treating doctors, providing information on diagnosis, onset, course and current status of the illness(es), and describing the associated limitations. These reports need not be addressed to DIGNITAS, nor does a reason need to be given for wanting them. Neither the doctor’s consent is required, nor does the doctor need to be aware of, or assess, the wish to die. It should be noted that:
• all pages are present (with consecutive page numbers)
• all pages are clearly legible
• the most recent report is no more than 3–4 months old
• the reports clearly show the title, medical specialty, name and address of the doctor
• reports on laboratory or imaging examinations also include an interpretation of the findings
If the reports are not written in German, English, French or Italian, we require them together with a translation by a certified translator.
It is therefore important that, during your illness, you already have copies of your medical reports made for your own medical file. If such reports have to be obtained only once an urgent situation arises, this can lead to difficulties and delays.
The Provisional Green Light
As soon as DIGNITAS is in possession of the complete request, it can be processed and forwarded for assessment to one of the Swiss doctors who cooperate with DIGNITAS. If they agree to an accompanied suicide, DIGNITAS informs the member of this as their “provisional green light”.
The provisional green light is a doctor’s preliminary consent, based on the request and medical reports. However, the final decision always remains subject to a personal consultation with a doctor.
Preparation for an Accompanied Suicide for People residing in Switzerland
We recommend that members residing in Switzerland first discuss the possibility of an accompanied suicide with their family doctor or treating physician. In principle, any Swiss doctor with a licence to practise – regardless of their specialty – may review requests for an accompanied suicide and decide whether they are willing, in that specific case, to issue a prescription for the lethal medication and thus grant the provisional green light.
Planning the Accompanied Suicide
Once the doctor has given provisional green light, we inform the member accordingly. If the member decides to proceed with an accompanied suicide, the further procedure is discussed with regard to the necessary documents, travel, accommodation and personal consultations with the doctor. Generally, several days need to be planned for the stay in Switzerland.
Only once everything has been clarified should the member travel from abroad to Switzerland where the accompanied suicide can take place in premises provided for this purpose.
This is subject to a Swiss doctor being consulted twice and that doctor confirming their consent after the second personal meeting, then issuing the prescription.
The medication used for the accompanied suicide is Sodium Pentobarbital (NaP), an approved sleeping and narcosis drug. It is listed as a controlled substance. Its handling is therefore strictly regulated. In Switzerland it is only available on prescription from a doctor with a licence to practise. This doctor must be familiar with the member’s medical history and must have met them in person.
Because transporting NaP across national borders constitutes the criminal offence of drug trafficking, no one is permitted to travel abroad with it.
The Course of the Accompanied Suicide
The staff of DIGNITAS collects the medication and brings it to the agreed appointment.
After the member and their family arrive, the procedure is discussed and any final questions are clarified. The member may, of course, discontinue the accompanied suicide at any time before taking the NaP.
Before NaP can be ingested, the member is given medication to calm the stomach. Thereafter, a small volume of liquid in which NaP has been dissolved can then be drunk.
Anyone who is no longer able to swallow has the option of ingesting the medication intravenously. In every case, the member must always carry out the final act (drinking or releasing the intravenous ingestion) themselves. If this is not possible, DIGNITAS cannot conduct an accompanied suicide.
After ingesting the medication, the member falls asleep within a few minutes then slips into a deep coma. After some time, their breathing becomes shallow and eventually stops. Death occurs peacefully and painlessly. One member’s last words to his spouse were: “I feel fine; everything is so relieving.” Next of kin experience the proceedings as dignified and peaceful, which helps them to handle events afterwards very well. The empathetic accompaniment and support given by the DIGNITAS staff contributes substantially to this.
Attendance of Next of Kin and Friends
Preparing for an accompanied suicide is a significant process for both the member and their family. Family and friends should be involved from the outset.
It is not uncommon for family members, who are initially opposed to the wish for a self-determined end of life, to change their mind in the course of the process and ultimately to accompany the member on their final journey. DIGNITAS encourages and welcomes the attendance of next of kin at an accompanied suicide.
Having that opportunity to say meaningful goodbyes to one another helps to come to terms with the loss more easily.
DIGNITAS is also there for the family members involved after an accompanied suicide.
DIGNITAS has long-standing Experience
Founded in 1998, DIGNITAS has assisted many individuals to end their suffering and life in a selfdetermined manner. Within the limits of legal possibility, DIGNITAS is open to all people – regardless of their place of residence, nationality, or faith and religious affiliation.
Only a small percentage of members of DIGNITAS who have prepared an accompanied suicide actually make use of it in the end. Some are able to “let go” once they have received the provisional green light.
Knowing about a legal and safe “last resort” means that people often regain some quality of life. It allows them to distance themselves from any thoughts of unaccompanied suicide.
DIGNITAS and the freedom to determine the manner and the time of the end of one’s suffering and life therefore have a life-prolonging and suicide-attempt-preventive effect.
A striking example of this is the case of one of our members who suffered from multiple sclerosis (MS) and received the provisional green light from a doctor cooperating with us. Some time later, they wrote to DIGNITAS that they now felt much better. They had suddenly found a new perspective on life.
People contact DIGNITAS in a wide variety of situations. Accordingly, DIGNITAS provides individual advice and, together with the person concerned, looks for a solution appropriate to their particular situation – as well as aiming towards life and other options, such as palliative sedation.
Challenges
The long-standing commitment of DIGNITAS to issues such as removing the taboo surrounding suicide has repeatedly been criticised and controversially discussed.
For DIGNITAS, respect for human freedom and the right to self-determination, as well as each individual’s personal responsibility, are of paramount importance.
It is also important to DIGNITAS to take a position on the challenges associated with:
• the question of suicide prevention and suicide-attempt prevention
• the question of whether a service should be provided only to residents of Switzerland or also to non-residents
• the question of whether, and up to what point, an accompanied suicide is possible in cases of progressive dementia
• the question of whether people with psychiatric diagnoses (for example schizophrenia or depression) should also have access to an accompanied suicide
• the question of whether accompanied suicide should also be open to people who are “tired of life”
DIGNITAS gives intensive consideration to the question of suicide-attempt prevention. Worldwide, hundreds of thousands of people die by suicide every year. Far more suffer severe physical, mental and psychological harm as a result of failed suicide attempts. This has further consequences for their families or third parties, such as train drivers, the public healthcare system and the economy. It is important to lift the taboo surrounding the issue of suicide to allow it to be discussed openly, as with questions surrounding the termination of pregnancy. It is a human duty to talk about this, and to look for solutions together.
DIGNITAS takes the view that it is not justifiable to make a distinction based on a person’s place of residence when they are suffering severely. This would amount to inadmissible discrimination and thus a violation of Article 14 of the European Convention on Human Rights (ECHR).
People with cognitive impairments (e.g. dementia, Alzheimer’s disease, etc.) also have access to the option of an accompanied suicide, as long as they remain capable of judgement. The relevant window of time is individual for each person.
People with psychiatric diagnoses can be capable of judgement. For this reason, they too should, if possible, have access to an accompanied suicide. The same applies to people without a severe illness who, due to their advanced age, wish to end a life that has become too burdensome for them.
A Word on Religious Questions
It is rare that interested parties or members raise religious questions in connection with accompanied suicide. Rather, this is raised by representatives of the churches in public debate and discussed controversially. DIGNITAS has conducted accompanied suicides for people of various religious affiliations and faiths. A priest was sometimes among the persons close to the member.
The human need for support in personal self-determination and freedom of choice is central to DIGNITAS.
Information on the costs associated with an accompanied suicide with DIGNITAS
- Preparation of an accompanied suicide
Significant administrative expenses are incurred by DIGNITAS when making the arrangements for an accompanied suicide up until the “provisional green light”. Getting a provisional green light means that a medical doctor has given basic approval to a member’s request for an accompanied suicide, yet reserves his or her definite decision until a personal consultation. Based on the DIGNITAS statutes, members are asked to pay a special membership fee of 4,000 Swiss Francs, which must be settled in advance. For legal reasons, no guarantee of an accompanied suicide can be linked to this payment.
- Doctor’s consultation(s)
Further costs will be incurred when a Swiss medical doctor who cooperates with DIGNITAS must be involved to meet a member and subsequently write the prescription for the drug. Two extended consultations with the physician and related administrative charges cost 1,000 Swiss Francs.
- Costs for conducting the accompanied
suicide
When conducting an accompaniment DIGNITAS incurs costs such as for staff, etc. In order to cover these costs, DIGNITAS charges 2,500 Swiss Francs.
- Funeral and registry office expenses
If a person dies at DIGNITAS in Switzerland rather than in their own home, costs are incurred for the services of the local funeral director. Cremation in Switzerland is generally recommended and the urn containing the ashes can be sent on or picked up and taken away. Scattering of the ashes in Switzerland is also possible.
The costs for the services of the funeral director, including a cremation, usually amount to 2,500 Swiss Francs, including charges payable to the relevant Swiss authorities and the cost of despatching the urn.
On request, DIGNITAS can also take care of the official procedures following a death in Switzerland. This separate service incurs an additional contribution of 1,000 Swiss Francs, to cover expenses.
Upon agreeing on a date for an accompanied suicide, the member will receive an invoice for advance payment, detailing the fees they are required to pay. An accompanied suicide can only be conducted if all costs and expenses incurred by DIGNITAS are covered.
If DIGNITAS is asked to make all the necessary funeral and administrative arrangement, an advance payment of 11,000 Swiss Francs is necessary. If DIGNITAS is not required to take care of the funeral or administrative/official affairs, the fee is 7,500 Swiss Francs.
In all amounts VAT not included. All fees are subject to change.
In the interest of proper accounting procedures, members are invoiced accordingly for these separate services, and the invoices must normally be settled in advance.
For members who live under modest economic circumstances, the DIGNITAS statutes make provision for reduction of or even complete exemption from fees. It is essential that any reduction or exemption is formally applied for, discussed and agreed beforehand between the member and DIGNITAS. If applicable, please contact DIGNITAS for specific information.