Years ago, I traveled to Zurich while en route to the Middle East. Before I got to this beautiful Swiss city, I mostly focused on all the chocolate and fondue I’d eat upon arrival.
Then I learned about physician-assisted dying (PAD).
Now I’m a traveling death doula, and the laws in Switzerland around death/dying are unique. So let’s cover what I’ve learned.
Death Tourism in Switzerland
Countries like Australia have laws permitting voluntary assisted dying (VAD) but for their residents only. In places like the Netherlands, they call this process euthanasia and allow people to travel to Amsterdam for this service.
Switzerland is more well-known for allowing non-residents to travel for PAD, but the process is complex and requires careful planning.
“In Love” by Amy Bloom
In Love: A Memoir of Love and Loss by Amy Bloom is about her husband Brian’s decision to end his life after being diagnosed with Alzheimer’s disease. It chronicles their search for a dignified way to do this. They discuss carbon monoxide poisoning, stopping eating and drinking, as well as fentanyl overdosing.
Amy and Brian eventually settle on traveling to Switzerland. They go through a lengthy and expensive process to end Brian’s life, detailing the psychiatric and neurological consultations, air travel, and paying a $10,000 fee. The book is a moving account of their love, marriage, and the process of helping a loved one die.
How to Die in Switzerland
Here’s how you would go about securing a peaceful and legal death in Switzerland.
Research and Contact a PAD Organization
Organizations like Dignitas or LifeCircle help guide non-residents through the process. These organizations require detailed medical documentation that demonstrates the person’s condition (usually a terminal or severe chronic illness) and mental capacity to make an informed decision.
You’ll need to submit comprehensive medical records. This includes the diagnosis, treatment history, and prognosis. Then a Swiss physician will review your case. They will likely request additional tests or consultations to confirm that you are eligible under Swiss law.
Timeline: 1 to 3 months
Physician Consultation
A Swiss doctor must meet with you in person before PAD is approved. During the consultation, the doctor will assess whether you meet the criteria, including mental competence to make the decision. If the doctor approves your request, the organization will schedule the procedure.
Some people might need to visit Switzerland multiple times. Others may need only one visit, depending on their circumstances.
Timeline: 1 to 2 months
Travel Plans
The organization often helps with logistics, such as travel arrangements and accommodations. Prepare all travel documents, including medical records, ahead of time. While there is no legal barrier preventing travel for PAD, Swiss authorities may scrutinize your visit. Some airlines may also require a fit-to-fly certificate, especially for people with serious illnesses.
Timeline: 1 to 3 months
PAD Procedure
Assisted dying in Switzerland typically involves taking a prescribed medication (usually a barbiturate) via an IV line. The process is designed to ensure that the person is fully informed and making a voluntary decision. Your loved ones may be with you every step of the way.
Most organizations also offer psychological and counseling services leading up to the procedure.
Costs
The costs vary but typically range between CHF 8,000 and CHF 10,000 (about USD 9,000-12,000). This covers medical consultations, organizational support, and legal documentation.
Ensure that your family and loved ones understand your decision, as they may need to handle legal and administrative aspects after your death. Swiss authorities require a death certificate, and some organizations help with body repatriation or cremation, depending on the person’s wishes.
Total Time Frame
Some cases might be faster, especially if all documentation is complete and there are no complications. However, for most, the process could take up to 6 months or longer, particularly if multiple consultations or additional medical assessments are required.
Given the complexity of the process, it’s crucial to plan well in advance and be patient. For individuals in critical or deteriorating health, it’s important to start the process early enough to avoid delays.
Ethical Considerations
Before choosing PAD in Switzerland, it’s essential to explore all medical and emotional options, including palliative care and counseling, to ensure this is the right decision. Traveling to Switzerland for PAD is a deeply personal decision and requires coordination with a legal, medical, and supportive network.
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What Happens to the Body?
The handling of the body follows legal and procedural steps, typically managed by the PAD organization. A doctor will confirm the death and issue a death certificate. This is required by Swiss law, and it ensures that the death occurred under legal conditions. The local authorities are also notified, and the death must be officially registered.
The deceased’s body is handled in a few different ways, depending on the individual’s or family’s wishes. Most PAD organizations in Switzerland offer cremation as a standard option. After the procedure, the body is transferred to a local crematorium.
The cremains are then sent to the family or retained in Switzerland, depending on the person’s prior arrangements.
If cremation is not preferred, families choose to have a funeral and burial in Switzerland. This is more complicated due to local burial regulations and costs, but it is an option.
Some families prefer to have the body repatriated for burial or cremation in the home country. This requires coordination with local and international authorities and is more expensive. The PAD organization or funeral service assists with the legal paperwork, embalming (if required), and transportation arrangements.
Repatriation costs vary but are generally high due to the logistics involved. Families should inquire about these costs in advance and decide on the preferred method of handling the body.
Do You Need a Doula?
Many organizations, like Dignitas, provide emotional support and counseling for families during this time, as well as assistance with paperwork and logistics. It’s also important for family members to be aware of their country’s laws regarding repatriation, cremation, or burial. The process is designed to be dignified and respectful, with careful attention to both legal and emotional needs.
However, sometimes the logistics get overwhelming. If you need more support from an experienced death doula, please reach out to me anytime.
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