Death wish - granted

03 October, 2008, 10:50

While a landmark case intended to clarify the country's assisted suicide legislation is taking place in Britain, the Swiss medical centre Dignitas is marking an anniversary of sorts. Since its creation in 1998 it has helped 100 Britons to die. It also happens to be the destination which Debbie Purdy, the case's instigator, has chosen as the place of her death.

Debbie Purdy suffers from a progressive form of multiple sclerosis that will lead to the degeneration of her body and wants to end her life should living it become intolerable. However, to do so, she would need her husband's help to travel to Switzerland, where assisted suicide is legal.

Purdy wants London's High Court to issue a ruling that would state that her husband would not be prosecuted for his assistance. Under current British legislation, he could face up to 14 years in prison if found guilty of assisting Purdy in committing suicide.

Her planned destination is the Dignitas Centre in Zurich. “Live with dignity, die with dignity” is the institution's motto. It was set up in 1998 by the Swiss lawyer, Ludwig Minelli. Patients who get in touch with the centre go through a standard procedure. First, they discuss their wish with the staff, establishing whether they should be allowed to die.

They then sign a document, which outlines their death wish and are taken to a flat owned by Dignitas. There, the patient is given an anti-sickness drug and a lethal dose of barbiturates which they administer themselves. Nurse Erica Lully, who prepares the medication, explained her role in an interview to the BBC:

“I bring the drink to the patient and once again ask, 'Is this your last day because this will be your last drink. Afterwards it's over, you will sleep two to five minutes and afterwards you will die'.”

Then, Dignitas staff confirm the fact of death and call the police to remove the body and establish the cause of death. All of the proceedings are filmed in case questions arise on whether the patients administered the medication themselves.

All of the centre's staff work on a voluntary basis in order to comply with Swiss assisted suicide legislation, which states that “whoever lures someone into suicide or provides assistance to commit suicide out of a self-interested motivation will, on completion of the suicide, be punished with up to five years' imprisonment.” Voluntary work is interpreted by Dignitas as altruism and so permission is granted to assist in suicides.

The centre has never had any problems with the police. They did, however, have to move the location of their flats to a remote business centre as they have received complains from their previous neighbours, who claimed that the presence of dead bodies and hearses in their vicinity was distressing.

Assisted suicide laws around the world.

Three countries currently legally allow assisted suicide: The Netherlands, Belgium and Switzerland. The U.S. state of Oregon also allows physician-assisted suicide. Out of the four, Swiss laws are the most liberal: they do not bar foreigners, do not require the presence of two doctors (unlike all the other locations) and permit assisted suicide in cases of terminal illness, or simply hopeless conditions. In 2001 the Swiss National Council confirmed the assisted suicide law but kept the prohibition of voluntary euthanasia.

Russia has no tolerance on assisted suicide. The killing of another at his own request is murder, as the consent of the victim is irrelevant in such a case. The 1993 law 'On Health Care of Russian Citizens' strictly prohibits the practice of euthanasia as well. Russia has a harsher legislative climate than in most countries, where there is a differentiation between murder and assisted suicide.

Fact file – Assisted suicide vs euthanasia

Assisted suicide occurs when a person – typically someone suffering from an incurable illness or chronic intense pain – intentionally kills himself with the help of another individual. This includes, for example, a doctor intentionally prescribing a lethal dose of a drug to a patient who intends to administer it, or the insertion of a needle into the patient's arm. The key aspect of assisted suicide is that the final deed remains in the patient's hands.

Euthanasia, on the other hand, requires active involvement in the act of suicide by somebody other than the patient. Euthanasia may be active, such as when a doctor gives a lethal injection to a patient. It can also be passive, in cases where a physician doesn't resuscitate a patient whose heart has stopped. Alternatively, it can happen when a doctor removes life-support equipment.