Will you qualify? What if you’ve got Parkinsons, Dementia or are taking medication for Depression?

“You need to know who you are, where you are and what you’re there for. You must also be able to drink or twiddle a valve”

Just before a member turns on the valve to feed the sodium pentobarbital through the cannula and into the member’s bloodstream, the leader of the team at Lifecircle switches on a film camera in order that the following event can be recorded accurately.   The member is then asked, on camera,

• ​What is your name ?
• ​What is your date of birth ?
• ​Do you know where you are ? and
• ​Do you know what will happen if you open that valve ?

If all the answers are correct, then the member is told “you may now end your life.”

In other words, they are considered to have sufficient mental capacity if, having been through the application process, they can answer those straightforward questions.   People in the early stages of dementia can certainly do so.   In later stages even such simple tasks will have become impossible.   They will have left it too late.

Dementia

As a result, many people who have been diagnosed with some form of dementia have a difficult balance to reach.   As their powers of memory and reasoning decline, they must choose the moment when they have retained just sufficient discernment to satisfy the “mental capacity” test.   They will need to be “considered capable of taking a self-determined decision to end their life and to act accordingly”. Faced with this task, many choose to take the safer route of coming to Switzerland a bit too early – meaning that they have missed the opportunity to live for a few more rewarding months.

In September 2022 a report from the University of Minnesota said that people over 65 who have been diagnosed with Covid will also have a 69% greater chance of developing Alzheimer’s dementia within the first twelve months. If true, and it has already been confirmed by other studies, this will cause a big increase in the demand for services from the Swiss end-of-life centres. The centres themselves are likely, therefore, to refine their criteria for accepting such patients. There is no reason to believe, however, that they will make acceptance any harder.

Parkinsons

For sufferers of Parkinson’s Disease, the problem is more straightforward.   Can they, unaided, drink the drink or turn on the valve ?   They can use a straw if they cannot lift the glass.   But the actual, physical act of ending their life must be carried out by themselves.   That’s the law. Additionally, because Parkinsons in its later stages leads to a form of dementia, they would need to go through that same process as for dementia patients.

People who have any sort of neurological illness are likely need the facilities available in Switzerland, even if the UK law changes. In Oregon, for example, 72% of assisted suicides are for people with cancer. The proportion with a neurological problem represent only 11%. Of UK people travelling to Switzerland, by contrast, almost 50% do so for neurological reasons.

Medication for Depression

Just because you have been diagnosed as suffering from Depression, it doesn’t mean you are no longer capable of taking a sound decision about whether to end your life or not. It does mean you’ll have difficulty in finding a Psychiatrist or Psychologist who’s prepared to say so. And the Centres in Switzerland (particularly Dignitas) are likely to insist on such a certification. The Doctors may be worried about bad publicity or their Professional Indemnity insurance or they may not agree in principle with what you are proposing to do. This problem seems particularly prevalent for patients who are taking a medication called Mirtazapine. It may be possible to get the assessment carried out in Switzerland itself, though that will involve adding another day to your proposed stay there. Most people, faced with this problem, have just done a lot of ringing round – usually with ultimate success.