Gino Kenny Questions Dignitas on Irish Access to Assisted Dying
Gino Kenny questioned Sylvain of Dignitas about assisted dying access, citing Dignitas statistics and expressing concern for Irish residents who travel to Switzerland for physician-supported deaths. He pressed on numbers, eligibility rules, the stage of illness of people who use Dignitas, and legal risks for those who accompany them.
Dignitas statistics
The Dignitas representative said the organisation publishes statistics on Dignitas.ch - Knowledge, Statistics. Ireland accounts for 12 Irish residents since 2003, and the site includes membership figures, assisted-death data from 25 years of operation, and Swiss Office of Statistics charts comparing diagnoses, assisted suicides, do-it-yourself suicides, life expectancy and population.
Annual caseload and international membership
Dignitas reported members in almost 100 countries and an annual caseload of roughly 200 to 250 physician-supported assisted suicides in the last six to eight years. The majority of users come from countries where voluntary assisted dying is illegal, with neighbouring European countries identified as common sources of travel.
Eligibility rules and excluded groups
Kenny highlighted that some legal models - cited as US-style laws - limit access to people judged terminally ill and expected to die within six months. Those exclusions can bar people with long-term neurological disease, multiple sclerosis, amyotrophic lateral sclerosis, forms of dementia while competent, and severe psychiatric illness from accessing assisted dying under those models.
Timing, travel and legal consequences
The exchange noted that prohibitions at home can force people to travel to Switzerland earlier than they otherwise would, sometimes while still fully capable, and that some have travelled by ambulance to access assisted dying. Kenny raised the risk that accompanying or assisting someone can lead to prosecution at home - citing a high-profile 2011 case - creating a dilemma for families and friends.
Swiss practice and palliative support
The Dignitas representative stressed that Swiss practice requires the person to retain mental capacity and that Switzerland does not permit voluntary euthanasia - people must act themselves. He also noted that Dignitas can accompany people at home and that mobile palliative care teams increasingly provide support in place, an alternative to forcing travel abroad.
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A number of questions for Sylvain of Dignitas. Thank you for your ongoing work. As you said, as in your background, it is to live with dignity, to die with dignity, and I think that is very, very important, because those that come to Dignitas, they want to die, but because of circumstances, out of their hands, they have come to your services. I'm not sure you can give the figures that I'm looking for, but how many Irish people have availed of assisted dying in Dignitas Dignitas since the foundation of Dignitas? Could you give us those figures? The statistics is public on the website, and I have to quickly look it up as well. Ireland, it's 12 Irish residents since the year 2003. 12? Yeah. Okay. If you go to our website, Dignitas.ch, in the section knowledge, there is a subsection called statistics, and there you will find figures about membership, about assisted deaths out of the last 25 years of Dignitas operating, and also statistics provided by the Swiss Office of Statistics in regard of diagnosis of people that make use of assisted dying here in Switzerland, and a special chart comparing do-it-yourself suicides, life expectancy, population, and assisted suicides. Okay. And obviously, the majority of people that come to Dignitas per year are coming from a country that voluntary assisted dying is illegal. So, obviously, Britain, other countries in Europe, outside even Europe, how many people would avail of assisted dying in Dignitas per year? Can you repeat that question again? You mean from all over the world? Yeah, yeah. Yeah. We have members in almost 100 countries around the world, and we are at a level of around last six, seven, eight years, it's always been between around 200 and 250 physician-supported assisted suicides per year overall. Okay. So, for a year? And, yes, of course, the main number is, of course, mainly from neighbouring countries, from close countries here in Europe, and, of course, from countries where they do not have that choice. Yeah. And obviously there would be even people using services of Dignitas, even though in their country actually assisted dying could be actually legal. Is that that could be the case? Yes. Well, if the eligibility criteria is a problem, we have talked at the very, at the very beginning of this conversation, we have talked about the US-American law models, and which only allow access to assisted dying for people who are terminally ill, who are judged to be terminally ill, and expected to die within six months. So, everyone excluded, people with long-term neurological sufferings, multiple sclerosis, amiotrific lateral sclerosis, all forms of dementia, early stage dementia, when they are still competent, all people suffering from severe psychiatric illnesses, and so on and so forth. All these people are discriminated against in the United States, and it is logic that these people would then potentially go to countries like Switzerland where there is more freedom of choice. OK. And I know this is going to be a difficult question to answer, but of those 200 or 250 people per year that avail of assisted dying, what stage are they at in relation to their condition? I know this is extremely difficult to answer, because obviously it is difficult. There are situations, and there has been a number of cases in Britain, where people have gone to Switzerland because they want to be in full capacity, physically and mentally, to make that decision. But because of the prohibition in the country that they live in, they are forced to go early. I just don't think that is a terrible situation that people find themselves in. So maybe you can comment on that. And my final question is in relation to those that can accompany those that avail of assisted dying, because there has been a number of high profile cases in Ireland around this, where somebody, if they assist, accompany the person, they actually could be prosecuted, which is an absolutely ridiculous situation that people can find themselves in. But that is the law. If you accompany somebody, you could actually be prosecuted. There was a high profile case in 2011 in relation to this. But if you can answer them two questions, I would be very grateful. I think I mentioned it in the introductory statement that this is a huge, one of the big problems of jurisdiction which does not permit real freedom of choice for suffering individuals, that these people are either left to take matters into their own hands and try a violent suicide attempt by whatever, harsh method, rough method, or they go to Switzerland or another country which would provide more freedom. And yes, they would, of course, if they are so determined to make that choice, to determine the end of their own end in life, they would have to do that slightly earlier than what could be if they had that choice at home. And here in Switzerland, mental capacity of being able to do it yourself is always the base. We don't have voluntary euthanasia, so people, in any case, have to be still competent and still able to act themselves, which would be different if voluntary euthanasia was permitted. People go sometimes to, struggling for the right words, people go to extremes to get their choice, in that we had people coming with their ambulance from Britain to Switzerland to make use of an assisted suicide. So they can stay at home for a long time until they would have to use whatever to travel to Switzerland. But that's absurd. I mean, that must change. It cannot be that people need to travel abroad. It's the same as with abortion many years ago, where women from Ireland traveled to England to have that choice. And things like this must stop. It must be, law must be in a way to give a human right to people at their home. And that has a life-prolonging effect. Here in Switzerland, we accompany people at their home. People don't come to us. We go to their home. And we have more and more palliative care teams, mobile palliative care teams, going to the people's home instead of people, going to a palliative care ward. And this is the way forward. This is how it should be. Thank you. Thank you. Thank you.
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