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Swiss Suicide Clinic Dignitas
■ BBC, Times, Daiy Telegraph etc.
◆20081209
BBC News "
No charges over assisted suicide "
(
http://news.bbc.co.uk/2/hi/uk_news/england/hereford/worcs/7773540.stm)
◆20080825
Times Online "
Murky truth behind Swiss suicide ‘clinic’ Dignitas"
(
http://www.timesonline.co.uk/tol/life_and_style/health/article5006805.ece)
◆20080820
Times online "
It's time for a clear policy on euthanasia"
(
http://www.timesonline.co.uk/tol/comment/columnists/libby_purves/article4974332.ece)
◆20080803
Telegraph.co.uk "
Dignitas clinic in Switzerland claims to have helped 100 Britons die"
(
http://www.telegraph.co.uk/news/uknews/3122966/Dignitas-clinic-in-Switzerland-claims-to-have-helped-100-Britons-die.html)
◆20080802
Times Online "
Swiss clinic Dignitas has helped 100 Britons to die Dignitas reveals total as test case begins"
(
http://business.timesonline.co.uk/tol/business/law/article4863771.ece?&EMC-Bltn=KMH6M9)
◆20070603
Daily Telegraph "
Swiss suicide clinics 'helping depressives die'"
(
http://news.bbc.co.uk/2/hi/health/4643196.stm)
◆20060124
BBC News "
Dignitas: Swiss suicide helpers"
(
http://news.bbc.co.uk/2/hi/health/4643196.stm)
◆20081209
BBC NewsNo charges over assisted suicide
http://news.bbc.co.uk/2/hi/uk_news/england/hereford/worcs/7773540.stm
at 17:21 GMT, Tuesday, 9 December 2008
※ Daniel James was paralysed during a training session
No charges will be brought over the death of a paralysed rugby player in a Swiss assisted suicide clinic.
Mark and Julie James were investigated by UK police after the death of son Daniel, 23, of Worcester, in September.
Director of Public Prosecutions Keir Starmer QC said there was "sufficient evidence" to prosecute the couple.
But he said their "fiercely independent son" had not been influenced by his parents and so charging them would not be in the public interest.
Custodial penalty 'unlikely'
Mr Starmer said: "While there are public interest factors in favour of prosecution, not least of which is the seriousness of this offence, I have determined that these are outweighed by the public interest factors that say that a prosecution is not needed.
"In particular, but not exclusively, I would point to the fact that Daniel, as a fiercely independent young man, was not influenced by his parents to take his own life and the evidence indicates he did so despite their imploring him not to."
He added: "I consider it very unlikely that a court would impose a custodial penalty on any of the potential defendants... in all probability the sentence would be either an absolute discharge or, possibly, a small fine."
※ Not a day has gone by without hoping it will be my last
Daniel James in a letter to the clinic
Mr Starmer said that Mark James had told him in interview that "even up to the last second... I hoped he'd change his mind... and my wife... I know she felt exactly the same.
"
The Crown Prosecution Service said no charges would be brought against a family friend, also under investigation by West Mercia police, who helped with the travel arrangements to Switzerland.
Mr James, a third year construction engineering student at Loughborough University, had played for Nuneaton Rugby Club, the England Universities rugby team and England Students team.
He was paralysed from the chest down, with no independent hand or finger movement, as a result of an injury sustained in a scrum while training at Nuneaton Rugby Club on 12 March, 2007.
Eight months later he was informed he would never make a significant recovery.
After the accident he tried to kill himself three times.
His parents were at his bedside when he died at the Dignitas clinic in Switzerland on 12 September.
Writing to Dignitas, Mr James said that "not a day has gone by without hoping it will be my last".
Psychiatrists said Mr James had arrived at his decision using clear, coherent and logical thought processes.
A consultant psychiatrist said after an assessment in March that Mr James was "fully aware of the reality and potential finality of his decision".
The campaign group Dignity in Dying welcomed the CPS's decision and said the law should be clarified.
The organisation's head Sarah Wootton said a lack of a safeguarded choice forced people into making "desperate and often dangerous decisions".
She said: "People are travelling abroad to die, there are 'mercy killings', botched suicides and some doctors already assist their patients to die at great potential cost to their livelihood and freedom."
◆20080825
Times Online Murky truth behind Swiss suicide ‘clinic’ Dignitas
http://www.timesonline.co.uk/tol/life_and_style/health/article5006805.ece
※ Dignitas is operating at present in a building on a shabby industrial estate
Roger Boyes in Zurich
The Swiss call it the Gold Coast, the string of silent, discreetly guarded villas fringing Lake Zurich. Bankers, tycoons and the heirs to family fortunes live here, so the lakeside is fenced off and there is only one narrow rocky strip where the public can plunge into the water.
That is where hundreds of small fragments of bone were recently washed ashore, the macabre flotsam from leaking crematorium urns. Who is dumping human ashes in the lake in such industrial quantities? Accusing fingers were, rightly or wrongly, pointed at the assisted-suicide organisation Dignitas, which claims to have helped 100 Britons to die. These include, most controversially, a 23-year-old rugby player who had been paralysed in a training accident.
The Crown Prosecution Service is deciding whether to press charges against the parents of Daniel James after it learnt that they had accompanied him to Dignitas, where he ended his life last month. The case has provoked sympathy and condemnation in almost equal measure because, unlike most previous cases, Mr James was not terminally ill. But that is not the only cause for concern about the organisation.
“I calculate that about 300 Dignitas customers have had their ashes dropped into the lake over the years,” said Soraya Wernli, who once worked in a senior position there. Police were unable to pursue an investigation because no laws were broken but the authorities did issue Dignitas with a warning that too much human ash could pollute the Gold Coast, against local regulations.
One thing is for sure: it is not how British families imagined the final resting place for their relatives. But then so little about about the workings of Dignitas matches its idealised image.
Dignitas, which says that it is a nonprofit organisation, has not published its figures since 2004. Its rationale is that it is driven by its members (6,000 have signed up, 700 from Britain) and their desire to control the nature of their death. Yet even Ludwig Minelli, its director, admits that he rules like a “benign dictator”.
There is talk, too, of a “Dignitas Clinic”, which conjures images of crisp Swiss efficiency, mountain air, a kind of peace. The reality is rather more shabby. While the organisation maintains a solid air-conditioned head office in a dormitory suburb of Zurich, the location of the assisted suicides is constantly changing. The present address is a second-floor apartment at Ifagstrasse No 12, an urban wasteland about 15 km (9 miles) from Zurich. Down the road is the Globe brothel, which is garlanded with a dozen flags representing the different nationalities of the girls inside. Near by, a Caribbean club, a Greek internet cafe and, next to the suicide apartment, a place where you can change your car oil.
Switzerland allows assisted suicide by a nondoctor provided that it is not done for profit. That is the most liberal ruling in Europe and its principles were set out as early as 1918: “In modern penal law suicide is not a crime . . . aiding and abetting suicide can themselves be inspired by altruistic motives.”
Even critics of Dignitas such as Andreas Brunner, the state prosecutor in Zurich, accept the principle. “But there should be tighter controls, regulating the quality of the help offered,” Mr Brunner argued. “And more transparency when it comes to individual cases, to finances and to the organisation itself.”
The real concern is not the practice of helping people to die ? one Swiss organisation, Exit, has helped more than 700 Swiss citizens and has escaped most political criticism ? but the tarnished image that comes with being seen as the suicide capital of Europe. Opponents call it “death tourism”.
Gerhard Fischer, of the Evangelical People’s Party, a powerful voice in the German-speaking part of Switzerland, said: “It has got out of control. I’m a farmer but I have to take a course before I so much as inject a calf, yet you don’t need anything at all to send a human to his death. It has become a business.”
Even so, the Government has resisted any major change in the law, and it is left to others to make life difficult for Dignitas. Medical supervisory boards have piled the pressure on doctors who write prescriptions for the deadly sodium pentobarbital. Three have been removed, and the present pivotal figure, Dr Alois Geiger, a gynaecologist, told The Times that he was “feeling the pressure from above”.
The law requires that a doctor see those who wish to die at least twice before they are ushered to the “death room”. Dr Geiger said that he was scrupulous about the rule. In the case of the most controversial patients, those who were not terminally ill, he said that he took particular care. “In these situations we insist on a longer interval between the first and second consultations, an interval of at least eight weeks, so we make sure that the person in question knows what he or she is doing.”
Ms Wernli, who left Dignitas in 2005 after a clash with Mr Minelli, said that it did not always work like that. “Some foreigners --- Germans and English --- would come to Zurich in the morning, be taken to the doctor and by mid-afternoon they were dead.”
Dignitas has denied that it is running a conveyor belt operation. Dr Geiger said: “You have to understand, before I see anyone there has been on average five months of communication. I am given the full medical history of the individual.”
It is not in the interests of a controversial organisation for people simply to vanish, prompting some form of police investigation. Many suicidal individuals are like wounded animals, ready to curl into a ball. Others want to end their lives exactly because they are socially isolated, cut off from families. For whatever reason, Dignitas has reconnected the lives of some of these people before they die.
Dignitas’s 75-year-old director is a former journalist and a lawyer, not a medical doctor. His journalistic experience is used to block off unwanted media attention ? he agrees to interviews only when he feels sure that they won’t delve too deeply ? but his legal skills have been vital in his weaving through the rules and staying on the right side of the law.
It was the Waste Disposal, Water and Energy Department that sent a warning to Dignitas about the human remains in Lake Zurich. And it is the local housing authorities that keep Dignitas on the run. Again and again, landlords or councillors have complained that Dignitas, which rents accommodation using the names of individuals, is transforming residential space into commercial space.
The real reason is clear: after someone has killed himself, the police are informed. The coroner and a doctor arrive, watch the video that has been shot shortly before in which the would-be suicide makes clear he is acting of his own free will. Testimony is taken. An “unnatural death” is entered on the forms. While this is going on, an ambulance, usually paid for by the family of the recently deceased, is standing outside, blue lights flashing, ready to carry the body to the Institute of Forensic Medicine in Zurich in case a postmortem examination is ordered --- and then to join the queue for cremation. It is the remains that are not claimed by families or friends that Dignitas is thought to be dumping.
The commotion makes the neighbours nervous and after several body-bags, complaints are lodged. Opinion polls regularly show 60 per cent or more Swiss citizens approving of assisted suicide for those with terminal diseases or with severe disabilities, but approval melts quickly if it is carried out on their doorstep.
“There are times when this charity resembles a guerrilla movement,” said a reporter who has followed Dignitas since it started in 1998. “It’s restless, constantly on the move.”
Thrown out of one apartment, searching for another, Dignitas has helped people to die in camper vans, hotel rooms and even Mr Minelli’s living room. When the organisation ran out of prescribed barbiturates, it used helium gas, a practice that has now been dropped.
There is no evidence that Mr Minelli is making a profit from the activities of Dignitas. It is a tax-free charity but it nonetheless should be having its books audited. No one in local council offices was able to explain to me why the Dignitas books are not being presented in the usual way. It seems unlikely, despite the rapid growth in Dignitas clients over the past four years, that Mr Minelli is making a fortune out of his grisly trade. The arithmetic does not add up: it has assisted in almost 900 suicides over the past decade. The most that anyone seems to pay is ￡7,000 (￡5,500), depending on the services being offered, and after salaries, rent, legal costs and cremations are paid that seems to add up to a rather modest business. The 6,000 members --- many of whom want to be put on the suicide list when their disease becomes critical --- pay an entry fee of ￡125 and an annual ￡50.
Mr Minelli’s reluctance to be candid about money probably derives from his determination to be the absolute controller. “He is the secretary general, the chief executive, half of the board of directors and the accountant, all wrapped into one,” Ms Wernli said. One retired Swiss doctor who is no fan of Mr Minelli said that the organisation was almost certainly not a cash cow. “This man is not about money, it’s all about his power over life and death. He’s like the mythical ferryman of the Styx, taking people over to the other side. And what was the ferryman paid: a single coin?”
Deadly business
―― Ludwig Minelli, a Swiss lawyer, founded the group in 1998
―― Swiss law says that assisting suicide can only be unlawful if self-interested motivation can be proven
―― It serves two main functions, to assist patients with making a “living will” and to assist patients to conduct a painless suicide
―― By March 2008 Dignitas had assisted 840 suicides. It claims that more than 100 were Britons
―― Dignitas charges ?4,000 for assisted suicide and ?7,000 when it takes over family duties including funeral costs and medical fees
Source: Dignitas, Ludwig Minelli transcripts
◆20080820
The Times It's time for a clear policy on euthanasia
http://www.timesonline.co.uk/tol/comment/columnists/libby_purves/article4974332.ece
Assisted dying is not the same thing as assisted suicide: we need to tread very carefully - and sympatheticallyLibby Purves
The story of Daniel James is almost unbearable. Paralysed in a rugby scrum, he made several suicide attempts and finally persuaded his parents to take him to the Swiss Dignitas clinic to end his life. At 23.
His parents have been questioned by police; what happens next is anybody's guess. Since its inception Dignitas has left the British legislature mortally confused. Take Debbie Purdy, who has multiple sclerosis: she has challenged the Director of Public Prosecutions to state unequivocally whether or not her husband will be charged with assisting suicide (a 14-year sentence) if he takes her there, when she decides the time has come. Ms Purdy robustly says that, if the answer is yes, then she will go alone - and therefore much sooner. If he is in the clear, she can enjoy her remaining time. She deserves that clarity.
Earlier cases have produced only mutterings of “insufficient evidence” or “no public interest”, which is not enough to reassure the couple. The sooner the DPP decides, the better. Nor would this small step take us as far as Lord Joffe's proposed Bill on assisted deaths: allowing people to take the dying to Switzerland would be a typical, and not entirely toxic, temporary fudge until Britain grows up enough to debate the issue without the usual alarmism and political cowardice.
But Debbie Purdy has an incurable degenerative disease and all she wants is permission to shorten the last painful months. Knowing there is an escape route might be so comforting that you never use it. Many terminally ill people willingly live each day, particularly if they get palliative care and comfort from the hospice movement rather than suffering in a stressed, overlit general hospital. But the law on Swiss-bound helpers must be clarified. Dignitas will not be un-invented.
However, assisted dying is not the same thing as assisted suicide. Even in Switzerland it is illegal to help a healthy but depressed person to die. There have been some troubling cases: three years ago a couple with chronic but not fatal illnesses ended their lives there, to their family's horror; more recently a healthy German woman faked a medical certificate to do the same. In an unnerving comment the Dignitas leader, Ludwig Minelli, admitted that six clients were depressed rather than terminally ill, and said: “We should accept that when nature produces human beings there are mistakes, not only physical but mental mistakes.”
Whoa! Mistakes? The danger with euthanasia enthusiasts is that they develop an unwholesome keenness to tidy up the world by killing off those who can't appreciate it properly. It is at this point, oddly, that Lord Joffe's Bill becomes attractive: it applies only to the terminally ill, and if the “assistance” was taking place in the UK we could monitor it with our own values, whatever we decide those are. I doubt that Daniel James would have got his wish in those circumstances, not least because only 18 months - eight in hospital - had passed since his accident. One would wish anyone, at any age, more time to reflect: most suicide attempts in the newly paralysed (mostly men) come in the first year. They need intense support, example and information from outside the family as well as within. But even that might not have changed his mind, and legally harassing his stricken parents is in nobody's interests.
But thinking about Daniel James, something else occurs with force. The humane creed of disability rights, with its vocabulary of challenges and being “differently abled”, may have a less helpful side-effect. It may blind us to the utter, visceral awfulness of confronting a major disability, especially when young. As civilised people we do not allow ourselves to flinch at a half-wrecked body in a wheelchair; yet the flinch and the fear are still there inside. Actually, one reason I enjoy sailing with the mixed able-bodied and disabled crews of the Jubilee Sailing Trust is that, after 24 hours of lurching about and having your hat blown off, the barrier of shyness and pity evaporates. We are all shipmates, each limited in our own way, and fine about it.
But we should not prattle on about fulfilling lives, Paralympians, Stephen Hawking and the rest if it makes us belittle the terror and self-disgust of a fit young person, paralysed. No amount of pious wittering about the Disability Community should blind us to that psychological impact.
In the early 1980s Stewart Yesner, paralysed in a car accident, founded the International Spinal Research Trust (now Spinal Research). I met some of the founders: young men crippled by their own daring in cars or sport or the military, who in an equally gung-ho spirit resolved to throw their energy into supporting research on spinal nerves. Much medical opinion strongly opposed such “false hope”, insisting that it was necessary to encourage a fulfilling wheelchair life and never speak of cure. The young men ignored this, and adopted a daring logo of a wheelchair user rising. Their work has certainly advanced - though not completed - medical knowledge on spinal regeneration. They did it with humility, knowing that the answer might come too late for them; they showed larky macho humour, undertaking feats such as the Big Push (Land's End to John o'Groats in wheelchairs). They faced the grimness of paralysis, but shook their fists at it.
Listen to Simon Barnes, who broke his back on an assault course at 21 and then worked with the charity. On the website he describes: “A constant struggle against an excessive share of difficulties, frustration and fear... it's tough to live with a body that only half works. You need to have an inexhaustible strength of spirit... the most painful part of being paralysed for me is missing out on the overwhelming fulfilment that comes with a loving sexual relationship; those are the feelings that help define us as human beings and often lead to the beginning of new life.”
Yet 20 years on, he concludes: “Even though I would jump at the chance to get back all the things that paralysis has taken away from me, I'm starting to appreciate that the spirit can carry us through real heavy stuff.”
It can. As the Anglo-Saxon poet wrote: “Let the spirit grow stronger, courage the greater, will the more resolute, as the strength grows less.”
But never for a second should the rest of us take shallow comfort - or rush to condemnation - by lightly assuming that every new victim should stay the course and mutate into a cheerful paralympian or a saintly philosopher. It's very, very hard.
◆20080803
Telegraph.co.uk Dignitas clinic in Switzerland claims to have helped 100 Britons die
http://www.telegraph.co.uk/news/uknews/3122966/Dignitas-clinic-in-Switzerland-claims-to-have-helped-100-Britons-die.html
Dignitas clinic in Switzerland claims to have helped 100 Britons die
A total of 100 Britons are said to have been helped to die by the centre for assisted suicide in Switzerland.
By Martin Beckford, Social Affairs Correspondent Last Updated: 7:53AM BST 03 Oct 2008
Dignitas, which has operated in and around Zurich for 10 years, claimed the milestone figure was reached last month.
Among its British patients was Reg Crew, a 74-year-old motor neurone disease sufferer whose final hours were filmed for ITV's Tonight With Trevor McDonald.
Overall, 870 people have ended their lives with Dignitas, most of them German, taking advantage of liberal Swiss law on assisted suicide so they can die quickly and painlessly and at a time of their choosing.
The country's legislation states people who help others to die will not be prosecuted so long as they act altruistically and not to benefit themselves.
This is in contrast with England and Wales, where the law states that anyone who assists a suicide risks prosecution and a maximum jail sentence of 14 years.
Dignitas was founded as a non-profit organisation by a Swiss lawyer, Ludwig Minelli, adopting the motto: "Live with dignity, die with dignity".
Patients who contact the centre, most of whom are terminally ill or suffering from chronic, painful diseases, discuss their wishes with staff to establish whether they should be allowed to die.
Dignitas claims 70 per cent of people who contact it for information never get in touch again.
If they do decide to go through with the assisted suicide, the patient signs a document stating their wish in case it faces opposition, and are then taken to a flat owned by Dignitas after paying a fee of about ￡3,000.
The patient is given an anti-sickness drug, and half an hour later they inject themselves with a lethal dose of barbiturate.
They are filmed in order to prove they administered the drug themselves, with the video shown to police and a coroner after the death.
Less than five minutes after the injection, the patient slips into a coma and their heart then stops beating.
Dignitas staff check that the person is dead then call the police so the body can be removed and the cause of death established.
Last year Dignitas was evicted from its flat in Zurich after neighbours complained about dead bodies being taken in the lift and hearses parked outside, and has relocated to a business park in a nearby village.
◆20080802
The Times Swiss clinic Dignitas has helped 100 Britons to die Dignitas reveals total as test case begins
http://business.timesonline.co.uk/tol/business/law/article4863771.ece?&EMC-Bltn=KMH6M9
A flat in Zurich, belonging to Dignitas, where assisted suicides take place
Frances Gibb, Legal Editor
More than 100 Britons have travelled to Switzerland to make use of laws that allow assisted suicide, a practice prohibited in Britain.
The figure, released by Dignitas, the centre for assisted dying in Zurich, has been disclosed as a High Court test challenge begins today to the laws that ban aiding and abetting suicide.
Debbie Purdy, 45, from Bradford, who suffers from multiple sclerosis, says that the Director of Public Prosecutions (DPP) is obliged under human rights law to state when and in what circumstances he will prosecute people who help others to die.
Ms Purdy, a former marketing executive who uses a wheelchair and lives in a specially adapted home, wants to have the choice of ending her life if her illness becomes unbearable.
※ Related Links
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A date with death
She wants to be able to travel to Switzerland to end her life, assisted by Dignitas, but accompanied by her husband, the Cuban jazz violinist Omar Puente. Under the present law he could face up to 14 years in prison for assisting a suicide.
Dignitas was founded in 1998 by Ludwig Minelli, a Swiss lawyer who runs it as a nonprofit organisation. It takes advantage of Switzerland’s liberal laws on assisted suicide, which suggest that a person can be prosecuted only if they are acting out of self-interest.
According to Dignitas the number of Britons among its assisted suicides reached 100 last month. There is, however, no independent verification of its figures.
Ms Purdy told The Times: “What I really want in an ideal world is not to have MS - or for anyone to have it - and for us all to live happily ever after.
But that’s not going to happen. So what I am seeking in the High Court is clarity - in what circumstances would they prosecute? If they say that my husband can collate the information, push me on to the train but not buy the ticket, then at least I know were I am.”
The clarification might help to determine when she would die, she said. “If I know I cannot be helped at all, then I might have to consider going earlier than I would otherwise do, when I am more able. But if my husband is able to help me with some of it, then I can delay - it may give me more time.”
But Ms Purdy, who used to enjoy an active life with outdoor pursuits that included parachuting, insisted that she had made no decision as to whether she would want to end her life. “I want the choice, the option. I don’t know if I will ever reach the stage when my symptoms are unbearable. So far, I have thought things would be unbearable - such as having to have a catheter - but it’s not. And I have a marvel-lous care team, as well as my husband, who says he will never let me get to that stage. But I can't be certain.”
Saimo Chahal, a partner with the London law firm Bindmans, who is acting for Ms Purdy, said that the case, which could go to the House of Lords, could result in a change in the law. “We are arguing that the right to life and the right to a private and family life under the European Convention on Human Rights should be interpreted broadly and should include decisions about the quality of life, including decisions about death if the quality of life is no longer good enough,” she said.
“On a practical level it is argued that the DPP should prepare a prosecution policy which tells the public what factors he will take into account when prosecuting in this area.
“It is only right that the public should know if they are likely to be charged with a criminal offence.”
Ms Purdy won leave in June to bring the High Court challenge, which is backed by the campaign group Dignity in Dying. Sarah Wootton, its chief executive, said: “We hope that common sense prevails and the judicial review will clarify the law so people considering travelling to Dignitas will know where they stand.”
The case is the first big challenge to the law on assisted suicide since that brought by Dianne Pretty, who died aged 43 in May 2002 from motor neuron disease. Her effort to change the law so that her husband could help her to end her life was rejected by the House of Lords in November 2001.
Final journey
―― 3 areas outside Switzerland permit some form of assisted suicide: Belgium, the Netherlands and the state of Oregon in the United States
―― 650 Britons are currently members of Dignitas
―― 870 people have been helped to end their lives by the clinic
―― 100 of them were from Britain
―― 70% of those who request information about assisted suicide from Dignitas never contact it again
―― 1941 when Switzerland made assisted suicide legal
Sources: Dignitas; Euthanasia Research and Guidance Organisation
◆20070603
Daily Telegraph Swiss suicide clinics 'helping depressives die'
http://news.bbc.co.uk/2/hi/health/4643196.stm
By Bojan Pancevski Last Updated: 12:32AM BST 03 Jun 2007
Prosecutors are calling for tougher regulations on Switzerland's assisted suicide clinics after uncovering evidence that some of the foreign clients they help to die are simply depressed rather than suffering incurable pain.
The clinics, which attract hundreds of foreigners, including Britons, every year, have been accused of failing to carry out proper investigations into whether patients meet the requirements of Switzerland's right-to-die laws.
In some cases, foreign clients are being given drugs to commit suicide within hours of their arrival, which critics say leaves doctors and psychologists unable to conduct a detailed assessment or to provide appropriate counselling.
Andreas Brunner, the senior prosecutor of the Zurich canton, told The Sunday Telegraph: "We are not trying to ban the so-called death tourism, but the outsourcing of suicide must be put under stricter control.
"Prosecutors look into every suicide, assisted or not, and there are many cases where it is not clear whether the assisted person has chosen death in full possession of their decision-making capacity. But investigations are difficult due to lack of evidence after the suicide.
"We, therefore, demand that the federal government amend the legislation to enable closer and lengthier monitoring of suicide patients before their deaths."
Mr Brunner said that there had been a number of cases where prosecutors or relatives of people who committed assisted suicide had taken legal action against doctors or organisations, although he declined to go into details.
Swiss laws allow doctors to provide "passive suicide assistance" to people who are terminally ill or in great suffering, with patients given a cocktail of drugs that they must administer themselves.
A handful of clinics provide the service, with two, Dignitas and Exit International, also offering it to foreigners, who make up a large proportion of the 300 assisted suicides that take place each year.
A Dignitas member who desires suicide must apply in writing, proving illness and pain, with a doctor's proof and prognosis. There is concern, however, that foreign patients may find it easier than Swiss clients to provide fake medical and psychiatric records.
Questions over the screening of foreign patients first surfaced when it emerged that a 67-year-old German woman who committed suicide with help from Dignitas had presented the clinic with faked papers saying that she was dying of cirrhosis of the liver. It turned out that she had been suffering from alcoholism and depression. Dr Daniel Hell, of the Swiss National Advisory Commission on Biomedical Ethics, a government regulatory body, said: "We suspect there could have been cases where people who suffered from a temporary depression have been helped to their deaths."
Ludwig Minelli, the lawyer and journalist who founded Dignitas in 1998, said there was no need for further legislation. Accusing Mr Brunner of waging a crusade against Dignitas, he said: "If the investigations had a real basis I would have been summoned for questioning, but this has not yet happened. Mr Brunner only wants to perpetuate the suspicions because he hopes a law will be passed that will limit Dignitas."
◆20060124
BBC News Dignitas: Swiss suicide helpers
http://news.bbc.co.uk/2/hi/health/4643196.stm
Page last updated at 11:45 GMT, Tuesday, 24 January 2006
Assisted suicide is illegal in many countries
Swiss charity Dignitas has gained a worldwide reputation for helping people wth chronic diseases to end their lives.
Since it was founded in 1998 it has helped hundreds of people from across Europe to commit suicide.
This includes many from the UK, the first of who was Reg Crew, in January 2003.
The organisation was founded by Swiss lawyer, Ludwig Minelli, who runs it as a non-profit organisation with the motto: "Live with dignity, die with dignity".
It takes advantage of Switzerland's liberal laws on assisted suicide, which suggest that a person can only be prosecuted if they are acting out of self-interest.
・Legal basis
The law on suicide actually states:
Dignitas interprets this to mean that anyone who assists suicide altruistically cannot be punished.
Its specialist staff all work as volunteers to ensure there can be no conflict of interest.
They engage in detailed discussion about whether the patient's determination to die falls within the legal boundaries, and whether it is indeed the declared will of the patient.
Dignitas also provides a text for patients, which states their wish for assisted suicide in terms which cannot be misconstrued and which allows them to carry out their wishes even in the face of opposition, if necessary.
※ ASSISTED SUICIDE
Assisting a suicide carries a maximum sentence of 14 years imprisonment in England and Wales
None of the UK cases handled by Dignitas has so far involved any criminal charges, but many have resulted in police investigations
Several European countries have no crime of assiting a suicide: Switzerland,
Netherlands, Belgium, France, Germany, Sweden and Finland
"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".
・Peaceful and painless
Once the decision has been made, the patient travels to Zurich where he or she is taken to a Dignitas flat.
The patient is given an anti-sickness drug 30 minutes before the lethal dose of barbiturate.
A camera is set up to record the patient take the drug themselves - firm evidence that it was not administered by clinic staff.
The barbiturate is a colourless solution, bitter tasting, and comes in a portion like a small glass of sherry.
The dose is three times the normal lethal amount required, based on the patient's weight.
The patient drinks it and then may take a sip of orange juice.
Within five minutes they lapse into a coma, and the heart stops soon afterwards, apparently leading to a peaceful and painless death.
The police are then called, a coroner comes, they question the witnesses and look at the video.
"What we are doing is a friendly act... we have never had a problem with police," said Mr Minelli.
"The patient always makes the last act - swallowing the drug or opening a valve of a drip himself."
Nurse Erica Lully, who prepares the doses, told the BBC News website how she deals with patients in the last few minutes of their life.
"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'."
※ This will be your last drink - afterwards it's over, you will sleep two to five minutes and afterwards you will die
Erica Lully, Dignitas nurse
・Opposition
Despite the apparent demand for Dignitas' services, the group's activities have stirred up some opposition within Switzerland.
Beatrice Wertli, from the Swiss Christian democrats, has voiced concerns about the legal basis of an organised group promoting and carrying out assisted suicide.
"We feel the organisations are too pushy in helping people to commit suicide," she said.
And she is worried about the reputation it is giving her country.
"We do not want Switzerland to be a destination for tourism for suicide," she said.
※ We do not want Switzerland to be a destination for tourism for suicide
Beatrice Wertli, Swiss Christian Democrats