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Murky truth behind Swiss suicide ?clinic? Dignitas

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 café 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

Full post as published by International and UK Law on October 25, 2008 (boomark / email).