A quick guide to Dignitas

A reader recently asked if we could produce a guide to Dignitas, the Swiss assisted suicide organisation, together with some pros and cons. We are happy to oblige.

Please note Exit does not give personal advice about Dignitas beyond the publicly information on here and in our complete guide, Five Last Acts II. This guide complies with all applicable laws and is applicable at the time of going to press. We recommend all readers download the official information booklets from Dignitas at the end of this article

The pros

  • Reliability. The organisation was founded in 1998 and has run steadily in spite of setbacks and opposition. It has built up a solid organisation and set of procedures and uses experienced staff.
  • Only place offering assisted suicide for foreigners. Dignitas offers the possibility of full, legal, medical, assisted suicide for anyone living in the UK (or any other country). Other places offering assisted suicide or voluntary euthanasia, such as Belgium, Netherlands, Luxembourg or parts of the USA, do so only for their own citizens.
  • No ‘terminal illness’ requirement.
  • Doctor-prescribed drugs.
  • No requirement that suffering is confined to physical (mental suffering eligible). “Anyone suffering from an illness which will lead inevitably to death, or anyone with an unendurable disability, who wants voluntarily to put an end to their life and suffering can, as a member of Dignitas, request the association to help them with accompanied suicide.”
  • Complete service offered (including management of the body after death if required).
  • No compulsory waiting period.

The cons

  • Cost. This can run to anything from (for instance) £7,000 to £10,000.
  • No active euthanasia – the patient must take the final action him or herself.
  • Assisted death – and the required drugs – are only available at Dignitas premises. Persons cannot be assisted unless they travel to Switzerland and cannot take drugs away with them for use at a future date.
  • Considerable paperwork. This is to ensure voluntariness, provide sufficient evidence for a prescribing doctor to give a ‘green light’ and also to satisfy Swiss legal regulations.
  • Bad publicity. Dignitas is frequently accused of bad practice – from dumping ashes in a lake to making exorbitant profits. Many of these stories come from a determined opponent and ex-employee of Dignitas. While readers will make up their own mind how much weight to give them, it should be pointed out that no charges against Dignitas have ever stuck, as far as we are aware (to the extent of making prosecution possible). There have also been concerns about shoddy premises – the back of a vehicle, a flat next to a brothel and so on – these are now laid to rest as Dignitas has acquired beautiful premises of its own (see photos).
  • Possibility of Swiss law being changed. Dignitas has come into conflict with the Swiss authorities on several occasions. There are moves in some parts to outlaw what is seen as ‘death tourism.’ However, legal change in Switzerland tends to take a long time.
  • Not ‘suicide on demand.’ The medical and legal requirements have to be followed strictly.
  • Timing. A time has to be arranged by mutual agreement. For some people this lacks the spontaneity of ending one’s life by one’s own hand – for instance by the methods outlined in Five Last Acts II. But there is always ample opportunity to change one’s mind, even after travelling to Switzerland.
  • Physical capacity. One must be able to at least drink through a straw or administer the drug in some other way.
  • UK legal problems for those left behind. This is much less of a problem now than it was, but accompanying someone to Switzerland, making arrangements and so on, can still be grounds for prosecution (In most cases, where they were clearly compassionate, no prosecution has resulted. Arrest and drawn-out proceedings are still possible before a prosecution is dropped.)

What is meant by ‘assistance?’
The goalposts on assisted suicide seem to be open to continuous interpretation in England & Wales – see the Director of Public Prosecutions guidelines; but one thing is certain: you cannot expect a doctor to prescribe lethal barbiturates for you in the UK. Most persons will be able to use the information in Five Last Acts II should they need to end their life – for instance by compression or correct use of helium. But a few – for instance those that are paralysed from the neck down – would find such self-deliverance very difficult if not impossible. Others may simply prefer to have the Swiss scenario, complete with medical reassurances.

What is meant by costs? (approximate)
Dignitas joining fee: £133 (200 Swiss francs / CHF)
Annual membership: £53 (80 CHF)
Preparation for an accompanied suicide £1,994 (3000 CHF)
Doctor’s fees £665 (1000 CHF)
Costs for completing an accompanied suicide £1,994 (3000 CHF)
Funeral services & cremation £1,329 (2000 CHF)
Completing official procedures (optional) £997 (1500 CHF)

That comes to £7,165 at current rates, even before you make additional annual membership payments. You must also find the resources for flights to Zurich, ground transport, and accommodation costs in Switzerland. There are many airlines flying from the UK to Zurich, and may cost anything from just over a £100 each (for you and whoever accompanies you) to two or three times that, depending on when you book and where you fly from. If Dignitas has to assist with documentation, then further costs are likely, and you will have small incidental expenses.

A word about names: There are many organisations worldwide with the name Exit. Switzerland has one, and there is also a high-publicity Australian touring society, ‘Exit International.’ We are not connected to any of these or responsible for their literature or practices.

Links

We have included (below) Dignitas’ official guide and FAQ – summaries have been published by various right-to-die groups (one Scottish group even charges – but it is exactly the same information!) You can also use the search facility in the right-hand column to look for other posts about Dignitas in the news that are featured on this blog.

Dignitas (various details including membership – free 14-page booklet)
How Dignitas Works (free 30-page booklet)
Inside Dignitas – a series of photos from The Guardian
Wikipedia page on Dignitas

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2 Responses to A quick guide to Dignitas

  1. Ricci says:

    “Conflicts of interest and biases exist in virtually every field of medicine, particularly those that rely heavily on drugs or devices. It is simply no longer possible to believe much of the clinical research that is published, or to rely on the judgment of trusted physicians or authoritative medical guidelines. I take no pleasure in this commentary which I reached slowly and reluctantly over many decades….one reason for the pervasive bias that is that physicians learn to practice a very drug-intensive style of medicine.” [emphasis added].
    The author of that candid observation was – Marcia Angell, M.D. who was for twenty (20) years the editor of…………….The New England Journal of Medicine. January 15, 2009, New York Review of Books, p. 12.

    • It’s a very important observation, Ricci. There are two different challenges that you have enumerated in your comment and that we tackle in our own research of meta-data for publications such as The Exit Path (TEP).
      i) The first, as you point out, is taking clinical research at face value. In one of the appendices of TEP, we examine a case where researchers relied on selective research regarding a method of self-delieverance. By examing a greater number of studies and comparing them we were led to the more supportable results overall that, unsurprisingly, correlated with a more intimate understanding of the physiology involved in the specific drug interactions. (This is even after filtering out such factors as outdated work, work using too small a sample, or in some cases even deliberate obfuscation.)
      ii) ‘Trusted physicians’ and ‘authoritative medical guidelines’ are likewise a starting point, not a final word. We never simply say, “this is true because someone said so.” The necessary step is to investigate and understand the science and logic behind statements made by physicians or medical bodies. Often they turn out to be completely correct (especially when it is a specialist in that field, for instance, toxicologists with long experience of the particular drugs, or neurologists with both theoretical and practical experience of a particular process in the brain); at other times, the opinion turns out to be an opinion based on general medical training only, or in some cases influenced by similar medical prevailing opinion. Medical bodies also can be interested in cost-efficiency savings. The way forward is to express the medical realities in words that can be understood by an intelligent, educated lay-person (which is what we do in the publications). All technical expressions can be broken down into simpler expressions – it is what doctors have to do when giving evidence to a Supreme Court, for instance. The wording can then be ‘peer-reviewed’ by another expert in the field to confirm that the medical realities have indeed still been correctly expressed (minus the medical jargon). It is a time consuming business (jargon saves time!), but a necessary one.
      A further test is to look at context. Encyclopaedias of toxicology, for instance, list amounts of drugs that can be fatal. This is very different to looking at amounts of drugs that will reliably be fatal. Similarly with shelf-life. When it says on a packet that a, “tablet should be used within a certain number of years,” it normally means that the expensive testing process has only been conducted for that number years. Most people use medicines within three years, so there is no incentive to test them for ten. Arriving at a realistic idea of usability is more complex (another issue that we have tackled in TEP).

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