Dignitas (Swiss non-profit organisation)

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Dignitas is a Swiss non-profit members' society providing assisted/accompanied suicide to those members of the organisation who suffer from terminal illness and/or severe physical and/or mental illnesses, supported by (of the organization independent) qualified Swiss doctors. They have helped over 2,100^[1] people die at home within Switzerland and at Dignitas' house/flat near Zürich. Additionally, they do advisory work on palliative care, health care advance directive and suicide attempt prevention and they have been leading and supporting numerous court cases and legislation projects for right-to-die laws around the world.^[2] Members of Dignitas who wish for an assisted suicide have to be of sound judgement, themselves able to do the last act which brings about death, and submit a formal request including a letter explaining their wish to die and most of all medical reports showing diagnosis and treatments tried. For people with severe psychiatric illnesses, additionally, an in-depth medical report prepared by a psychiatrist that establishes the patient's condition, is required as to a Swiss Supreme Court decision.^[3]

History and operation

Dignitas was founded 17 May 1998 by Ludwig Minelli, a Swiss lawyer specialising in human rights law. Swiss laws provide that assistance to suicide is legal as long as it is not motivated by selfish motives. The person who wishes to die meets several Dignitas personnel, in addition to an independent medical doctor, for a private consultation. The independent doctor assesses the evidence provided by the patient in advance and is met on two separate occasions, with a time gap between each of the consultations.^[4] Legally admissible proof that the person wishes to die is also created, in the form of a signed affidavit, countersigned by independent witnesses. In cases where a person is physically unable to sign a document, a short video film of the person is made in which they are asked to confirm their identity, that they wish to die, and that their decision is made of their own free will, without any form of persuasion / coercion. This evidence of informed consent remains private and is preserved only for use in any possible legal dispute.

Finally, a few minutes before the lethal overdose is provided, the person is once again reminded that taking the overdose will surely kill them. Additionally, they are asked several times whether they want to proceed, or take some time to consider the matter further. This gives the person the opportunity to stop the process at any time. However, if at this point the person states that they are determined to proceed, a lethal overdose is provided and ingested.^[5]

Suicide method

In general, Dignitas uses the following protocol to assist suicides: an oral dose of an antiemetic drug, followed approximately half an hour later by a lethal overdose of 15 grams of powdered pentobarbital dissolved in a glass of water. If necessary, the drugs can be ingested via a drinking straw. The pentobarbital overdose depresses the central nervous system, causing the person to become drowsy and fall asleep within 3–5 minutes of drinking it. Anaesthesia progresses to coma and later, as the person's breathing becomes more shallow, followed by respiratory arrest and death, which occurs within 30–40 minutes of ingesting the pentobarbital.

Exceptionally, in four cases in 2008, Dignitas used breathing helium gas^[6] as a suicide method instead of a pentobarbital overdose. The medical supervision was still observed, however, the prescription controlled drugs avoided, which reduced the risk of the medical board / authorities harassing the medical doctor giving a "green light" for the accompanied suicide.

Referendum

In two referenda on 15 May 2011, voters in the Canton of Zürich overwhelmingly rejected calls to ban assisted suicide or to outlaw the practice for non-residents. Out of more than 278,000 ballots cast, the initiative to ban assisted suicide was rejected by 85 per cent of voters and the initiative to outlaw it for people was turned down by 78 per cent.^[7][8][9]

Statistics

Ludwig Minelli said in an interview in March 2008 that Dignitas had assisted 840 people to die, 60% of them Germans.^[6] By 2010, that number had exceeded a thousand assisted suicides.^[10]

Most people contacting Dignitas do not plan to die but need insurance in case their illness becomes intolerable. Of those who receive the so-called "provisional green light", 70% never return to Dignitas.^[6]

21% of people receiving assisted suicide in Dignitas do not have a terminal or progressive illness, but rather "weariness of life".^[11]

Costs and finances

According to Ludwig Minelli,^[6] Dignitas charges its patients €4,000 (£3,182/$5,263.16) for preparation and suicide assistance, or €7,000 (£5,568/$9,210.53) in case of taking over family duties, including funerals, medical costs and official fees. Dignitas has been known to waive certain costs where there is hardship.^[12] Under Swiss Law, Dignitas operates as a non-profit organization, but does not open its finances to the public,^[13] which has elicited criticism from some quarters.

'Suicide tourism'

Although mainly Germans turn to Dignitas for so called 'assisted suicide', as of August 2015, approximately 300 British citizens had travelled to Switzerland from the UK to die at one of Dignitas' rented apartments in Zürich.^[14]

Allegations by Dignitas ex-employee

Soraya Wernli (a nurse employed by Dignitas for two-and-a-half years, until March 2005), accused the organization of being a 'production line of death concerned only with profits'.^[15] Wernli claimed many wealthy and vulnerable people bequeathed "vast sums" to Minelli in addition to standard fees and some were not terminally ill.^[15] She also complained some patients died in pain, and resigned after an alleged incident in which a new type of machine left a client suffering for 70 hours.^[15] Dignitas denied all allegations and pointed out that Wernli left Dignitas several years ago.^[15] Minelli said that "If the state prosecutors feel I’m making myself rich they should start legal proceedings."^[16]

Reaction of local Swiss people and authorities

Dignitas-founder Ludwig Minelli describes the difficulties that Dignitas has faced over the years.^[17] In Sept 2007, it was evicted, blocked or locked out of three flats, and so Mr Minelli offered assisted suicide in his private house. This, however, was then prohibited by the local council. In Oct 2007 Dignitas was again prevented from working in a private house by the local council and refused rooms on an industrial site. In Dec 2007 an interim judgment prevented Dignitas from working in a building next to a busy brothel. The media frenzy led to several people offering Dignitas flats or houses, of which one turned out to be suitable. Since 2009, Dignitas has a house at an undisputed location where accompanied suicide for people from abroad can take place.

Patient selection

Although Dignitas and Exit provide little or no data into its activities, it is known that 21% of people receiving assistance by Dignitas and 65% of women attending Exit do not have a terminal or progressive illness. In certain right-to-die organisations, an age restriction is in place for potential patients, so as to prevent young people from using their services.^[18]

Cremation urns found in Lake Zürich

In April 2010, private divers found a group of over 60 cremation urns in Lake Zürich. Each of the urns bore the logo of the Zürich Nordheim crematorium also used by Dignitas. Soraya Wernli, a former employee, had told The Times 18 months previously that Dignitas had dumped at least 300 urns in the lake. She claimed that Minelli dumped them there himself, but later asked his daughter and another member of staff to do it. In 2008, allegedly two members of Dignitas were caught trying to pour the ashes of 20 dead people into the lake.^[19][20] However, it was never established whether Dignitas had anything to do with it and no charges were taken. In Switzerland, it is not against the law to scatter cremation ashes out into nature.

Dignitas in media

In 2008, the documentary film Right to Die? was broadcast on Sky Real Lives (rebroadcast on PBS Frontline in March 2010 as The Suicide Tourist). Directed by Oscar-winning Canadian John Zaritsky, it depicts the assisted suicide of several people who have gone to Switzerland to end their lives.^[21] It includes the story of Craig Ewert, a 59-year-old retired university professor who suffered from a motor neurone disease. Ewert traveled to Switzerland where he was assisted by the Dignitas NGO. The documentary shows him passing away with Mary, his wife of 37 years, at his side. It was shown on the Swiss television network SF1 and is available as a web movie on the Dignitas website.^[22]

The BBC produced a film titled A Short Stay in Switzerland^[23] telling the story of Dr Anne Turner, who made the journey to the Dignitas assisted suicide clinic. On January 24, 2006, the day before her 67th birthday, she ended her life. The film was shown on BBC1 on January 25, 2009.

British maestro Sir Edward Downes, who conducted the BBC Philharmonic and the Royal Opera but struggled in recent years (but was not terminally ill) as his hearing and sight failed, died with his wife, who had terminal cancer, at an assisted suicide clinic in Switzerland in July 2009. He was 85 and she was 74.^[24]

French lesbian theorist and translator Michele Causse chose to die on her birthday, July 29, 2010, in association with Dignitas.^[25][26]

On June 13, 2011, BBC Two aired a documentary titled Terry Pratchett: Choosing to Die, featuring author and Alzheimer's disease sufferer Sir Terry Pratchett guiding viewers through an assisted suicide which took place at Dignitas facilities in Switzerland. Peter Smedley, a British hotelier and millionaire, and his wife Christine allowed for Pratchett to film Smedley's deliberate consumption of prepared barbiturate in a glass in order to kill himself as Christine comforted Smedley in his demise. The documentary received a highly polarized reaction in the United Kingdom, with much praise for the programme as "brave", "sensitive"^[27] and "important"^[28] whilst it also gathered accusations of "pro-death" bias from anti-euthanasia pressure groups and of encouraging the view that disability was a good reason for killing from disability groups.^[29][30]

Dignitas continued to be presented in the media as a political stance on the right to die. BBC featured an article regarding the death of UK citizen Jeffrey Spector, a businessman who decided to travel to Switzerland to undergo assisted suicide through Dignitas for an inoperable tumour which most likely would have caused paralysis later on in its development. This situation reignited the debate revolving around the morality of assisted suicides in certain dilemmas, and incited current stances concerning euthanasia. Former Lord Chancellor Lord Falconer said he would "attempt to reintroduce a bill that would allow assisted dying in the UK".^[31]

Both the book Me Before You and the movie discuss the organization as it serves a vital function in both the main plot and the characters' lives.

See also

• Assisted suicide
• Final Exit Network
• Jack Kevorkian
• Philip Nitschke
• Derek Humphry
• Betty and George Coumbias
• Right to Die? (documentary)

References

External links

• Exit home page
• Dignitas website
• Dignitas: Swiss suicide helpers (BBC news article about Dignitas, Last Updated: Monday, January 20, 2003, 14:38 GMT)
• Death of Sir Edward Thomas Downes, CBE at Dignitas (BBC News Item – July 2009)
• Jacob Appel. "Next: Assisted Suicide for Healthy People". Huffington Post. July 16, 2009.
• Guide to Dignitas by Voluntary Euthanasia Society of New South Wales
• Lydvig Minelli