talkhealth Blog

In this weeks news was the story of a woman in her seventies who travelled to a clinic in Switzerland to take advantage of Swiss law, which allows  an individual to choose to end their life. The article suggested that she did not have a terminal illness and did not suffer from unbearable pain.

The right to assisted dying is being and has long been debated .Today I do not want to get into the debate itself, but thought it would be interesting to understand a little of the process in Switzerland.

The association Dignitas was founded in 1998, just outside of Zurich. As I understand it, the organisation is non profit making, and has the objective of ensuring that an individual has the right “to live with dignity-to die with dignity”.

The law in Switzerland prevents the inducement or aiding of another to commit suicide if it is due to selfish motives, but does not punish an individual if there is no self interest. This is the legal basis on which Dignitas was founded.

I understand that for an indivdual to be helped to die that a number of preconditions need to be met. The first is that it is the individuals declared wish and that they have the mental capacity to make that wish. The organisation will help with drafting Patient instructions to ensure they comply with Swiss law. They also try to ensure that no other party is pushing them towards suicide. It is also my understanding that the individual should be suffering from a medically diagnosed hopeless or incurable condition, unbearable and uncontrollable pain or unendurable disability.Individuals are counselled in regard to all end of life issues and the organisation states that they are actually effective in suicide prevention in many cases. The individual also needs to be able to have sufficient mobility to administer a lethal drug themselves either by mouth via a gastric feeding tube or intravenously via a preinserted intravenous access point.

In order to take advantage of the service that Dignitas offers one needs to be a member of the organisation. There is currently a one off joining fee of approximately £150 and an annual fee of around £60.

When making arrangements for an assisted suicide there are additional costs Members pay around £2500 in administration fees in advance.There needs to be at least two consultations with a doctor who will potentially prescribe the drug required( normally a barbiturate).This will be around £740. Further costs to cover any escort ,the costs of  the  Dignitas apartment etc are around £1850.There are funeral and registry office expenses,around £1850 and official proccedures which cost around £740.

The Dignitas statute makes provision for a reduction or even exemption for members under certain economic circumstances.

According to their website Dignitas’ experience is that only a very few members take advantage of the service for assisted suicide. The majority feel protected and comforted by the Patient instructions and eventually have a natural death.

I believe most of us are not afraid of death, but of the mode of dying.I remain uncertain as to whether travelling to another country and ending ones life possibly prematurely whilst still capable of being able to do so is correct,  but I am certain that we all should have the right to die with dignity and without undue suffering. The debate will continue.

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Dr Roger Goulds

Dr Roger Goulds has over 30 years experience as a General Practitioner in both the NHS and private sector. He has also worked in health screening and is very keen on early diagnosis and disease prevention. He has a special interest in sports and musculoskeletal medicine and works with professional sports men and women.