Ludwig Minelli, a longtime director of an assisted dying organisation Dignitas, chose to take his life at his clinic on November 30th – a legal practice in Switzerland. Our comprehensive guide explains how this liberal law works.
From time to time, the subject of assisted suicide makes news in Switzerland.
On September 24th, for instance, police in Schaffhausen announced they had arrested several people from an assisted suicide organisation called The Last Resort, because it allowed its controversial Sarco ‘suicide pod’ to be used to end an American woman’s life.
READ ALSO: Swiss police make arrests after suicide ‘pod’ used by American woman
Though assisted suicide is legal in Switzerland (read more about this below), the problem is the manner in which the person died because the capsule has raised a host of legal and ethical questions in Switzerland since it was first unveiled in June 2024.
Coincidentally, just a day before this happened, Health Minister Elisabeth Baume-Schneider said that while the principle of assisted death is not banned, the way Sarco functions — that is, by filling the pod with poisonous nitrogen gas — does not comply with the existing Swiss legislation.
The main reason is that federal law requires that all products in Switzerland must be safe, and not endanger the health or life of users.
Sarco, which literally causes death, does not meet this condition, Baume-Schneider said.
What does the assisted dying law say?
Switzerland has had an assisted dying law on the books since 1942 — a constitutional right of each person to determine the manner of his or her death.
While many people across the world may be shocked by the medical community legally helping someone to die, in Switzerland it is considered a legitimate way to end one’s life.
(One important distinction to make is between assisted dying and euthanasia. The former requires the person in question to administer the lethal drug themselves, while euthanasia is where a doctor takes this final step. Euthanasia is not permitted in Switzerland).
While article 115 of the Swiss penal code prohibits assisted death for “self-serving reasons,” helping someone die for non-selfish reasons is not specifically prohibited — as long as certain conditions are met (see below).
Police inquiries can follow this act and prosecutors may take action if they feel a crime has been committed. However, Swiss ‘death with dignity’ organisation Exit notes on its website that autopsies are rarely performed
What are the conditions for assisted dying?
Switzerland’s Federal Court has ruled the following: people must commit suicide by their own hand by taking medication themselves. A doctor cannot administer a lethal injection without being liable for criminal prosecution (the aforementioned difference between assisted death and euthanasia).
Only people over the age of 18, who are mentally and physically capable of discernment, can make the decision to die.
People must also be aware of actions they are undertaking and have given due consideration to this decision.
In addition, they must be consistently sure that they wish to die. They must make this decision themselves and not be influenced by others.
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Must people suffer from terminal illness to be eligible for assisted dying services?
While for many years, only people suffering from medically-certified terminal conditions qualified for death assistance, rules have been relaxed over the years, to include disabilities and suffering.
While some organisations, like Exit, apply stricter criteria to the notion of illness and suffering — for instance, the patient has no chance of recovery, or lives with chronic and unbearable pain or disability — Swiss legislation in this matter doesn’t specifically apply to physical illness.
Mental distress, also defined as “existential suffering”, while decidedly a bit of a grey area that lacks definition, also falls under the “suffering” category.
According to a report co-authored by two Geneva medical ethicists, “suffering is surely not limited to disease status. If we consider relief from suffering to be one of the central considerations for assisted suicide, it is reasonable to think that the acceptability of a request should not exclusively depend on the diagnosis of an incurable or terminal disease”.
Who helps people die in Switzerland?
The main associations are Exit, Dignitas, Exit International, and Lifecircle.
Exit only provides assistance for citizens or legal residents of Switzerland, while Dignitas, Exit International, and Lifecircle provide services to foreigners as well.
READ ALSO: Can foreigners access Switzerland’s assisted suicide clinics?
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How does the paperwork process work?
The different associations have slightly different procedures, but both Exit and Dignitas stress that it is not possible to simply walk in off the street, collect the necessary medication, and commit suicide. Dignitas, for example, says the process can take three months or longer.
For both organisations, people wishing to use their services must be members. Dignitas specifies that for non-members, submission of a declaration of membership is a mandatory first step, although it also notes there is no waiting period between becoming a member and applying for assisted suicide.
Beyond that, Dignitas and Exit outline processes that include making first contact (either directly or through a family member), counselling and personal interviews, submission of medical documents and an exploration of other treatment options including palliative care. A prescription for lethal medication will then be ordered from a doctor.
Dignitas also notes there is a lot of paperwork involved when foreigners choose assisted suicide in Switzerland and this can be time-consuming.
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What is the medical procedure involved?
According to EXIT, the country’s largest assisted dying organisation, patients “must be able to ingest the lethal solution by themselves by holding the glass or using a straw. If this is not feasible, it is possible to use an intravenous perfusion, as long as the person requesting it has the physical ability to open the valve or operate the flow dial.”
It usually takes about 20 to 30 seconds for the patient to fall asleep.
To ensure that the process complies with the law, a video is shot of the patient stating their name, date of birth and that they understand what they are about to do. The camera keeps rolling as they open the valve that allows a barbiturate to begin flowing into their vein. This footage is used as evidence that they willingly took their own life.
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How much does assisted suicide cost?
At EXIT, Switzerland’s largest assisted dying organisation, an annual membership fee is 45 francs a year 1,100 francs for a lifetime membership.
As for Dignitas, since it is dealing exclusively with foreign nationals, costs are higher due to an increased administrative burden. membership costs 220 francs for a one-off joining fee, and 80 francs a year thereafter. People wishing to pursue assisted dying must also pay an upfront 4,000-franc fee, without any guarantee this suicide will go ahead.
A further 1,000 francs must be paid for medical consultations and the writing of the prescription for medication required.
Finally, if assisted suicide goes ahead, another 2,500 francs is charged to cover Dignitas costs, according to their website.
Dignitas can also organise funerals and oversee administrative affairs.
But is should be noted Dignitas can waive some or all costs for people in financial difficulties.
READ ALSO: Do Swiss cantons have different rules on assisted suicide?
