A chronically disabled man was brought by his family from Dublin to Switzerland for an assisted suicide late last year.The Irish Times has learnt that the man, severely disabled since an accident some years ago, travelled by air to Switzerland. He died in Zurich with the assistance of the Swiss right-to-die organisation, Dignitas, writes Dr Muiris Houston, Medical Correspondent.
The man, who needed to use a wheelchair, was in his 30s. He was taken from the Dublin hospital where he was a long-term resident for a routine weekend visit home. However, when he did not return as planned, the hospital authorities were told by his family that he had passed away in Switzerland.
The Irish Times has established that the disabled man, who was unable to feed or clothe himself, underwent an assisted suicide in a rented apartment in Zurich with the help of volunteers from Dignitas.
This group, founded in 1998, is the only one of four right-to-die organisations in Switzerland to offer assistance to foreigners.
Led by Ludwig Minelli, a lawyer, the organisation has a membership of over 2,000 people. Its volunteers offer to assist people with suicide, which is legal in Switzerland provided there is no personal motive or gain for those providing assistance. Swiss doctors are not permitted to assist in the process.
The man was involved in an accident some years ago which led to severe neck and brain injuries. While able to breathe unaided, he was unable to swallow and had a tube inserted into his stomach so that he could be fed.
The man was fully dependent on nursing staff for dressing and toileting. As a result of his brain injury, his communication skills were poor.
It is understood that he had expressed a wish to die on a number of occasions during his care in two separate hospitals. Following a neuropsychological assessment in 2000, the single man was deemed "intellectually competent". But it was also established that his wish to die had been inconsistent and that when acutely ill with infection, he had both requested and accepted treatment.
Dignitas usually brings the person and a relative to a rented apartment in Zurich. The volunteer gives the person a relaxant and an anti-nausea drug; about half an hour later a large dose of a barbiturate is administered either orally or through a feeding tube. Death occurs within two hours in the presence of both the relative and the volunteer. The Swiss police are then notified and a routine investigation takes place to establish the legality of the act.
According to Dr Deirdre Madden, lecturer in medical law at University College Cork, assisted suicide is an offence in the Republic under the Criminal Law (Suicide) Act 1993. "However, judgments in the X case have added weight to the facility of the right to travel to another state to avail of a procedure that is within the legislation of that country," she said in reference to the abortion "right-to-travel" case.
Medicolegal sources said last night that it was highly unlikely that the family of the man would face any legal sanctions in the Republic.
Asked to comment on the case, a medical expert in rehabilitation medicine said about two-thirds of chronically disabled people did not think about suicide. "While the public perception of a person might be that their life is not worth living, it is very important to ask the individual," he said.
The family of the man did not wish to comment yesterday.
In a statement Mr Minelli, the founder of Dignitas, said: "Relations between individuals and Dignitas are always ruled by the professional secret. So Dignitas is never entitled to give information to third persons without the consent of the concerned persons or their relatives."
Assisted suicide has been legal in Switzerland since 1937 and is specifically dealt with by articles in the country's penal code. However, doctors are prohibited by the Swiss Academy of Medical Sciences from professionally participating in assisted suicide.
Dignitas has over 2,000 members, many of whom live outside Switzerland. Founded in 1998 it is estimated the organisation has assisted over two dozen British people to end their lives. Dignitas is known to have assisted a British couple, Robert and Jennifer Stokes, in 2003. Neither was thought to be terminally ill but were suffering from psychological illness and chronic disease.
Some 91 foreign nationals are thought to have died in 2003 with the help of Dignitas.