Category: News

By Dr. med. Jakob Bösch (translated from German)

Thousands of people in Switzerland and tens of thousands in Germany die by suicide every year. No loving words of farewell, no holding hands, no last hug. They go alone into the water, alone in front of the train, alone in the garage with a rope. The hurdles for assisted suicide are too high for some of these people, and the prescribed examinations are humiliating and degrading for them. Sarco can offer a way out.

The now-established euthanasia organisations also had their wild pioneering years and had to fight against a lot of resistance. Time and again there were headlines and often worldwide media noise. Time and again there was outrage and abuse of the pioneers. Time and again, the authorities and political parties tried to ban them. Thanks to direct democracy and courageous and persistent pioneers such as Ludwig Minelli, it was possible to achieve the liberal Swiss regulations we have today. Surveys and political votes have always shown a very clear picture: The population wants liberal solutions!

The development continues now. It must continue. Of course, the established euthanasia organisations are not so happy about this. They are comfortably established and rightly proud of their successes. And they don’t want to be disturbed in their cosy routine by cheeky new pioneers. And politicians immediately hope for the chance to make a name for themselves by calling for a ban! But I have confidence in the Swiss population. As before, they won’t let their openness to new developments be taken away so quickly!

The controversy surrounding Philipp Nitschke is so much like the controversy surrounding former champions like Ludwig Minelli! That is a reason for relaxed confidence. I hope that Nitschke’s tenacity will be similar to that of the earlier pioneers!

This confidence can certainly not be shaken by a hasty and by no means a well-founded statement by a Federal Councillor.

The one-sided, somewhat romanticised generalisation of experienced end-of-life caregivers that people want to die at home surrounded by their loved ones is also valid for many, but not for all. There are also completely opposite wishes. Some people do not want to die at home, or in close proximity to other people. This form of dying should also be respected.

Why do people want to know better what a dignified death is for those affected? It is precisely this incapacitating know-it-all attitude that most damage the dignity of those who wish to die.

The Sarco can be transported to any country. It can probably soon be produced in other countries too. The unjustly demonised ‘death tourism’ is an important and democratic way to end one’s life in a self-determined manner. The easier it is to circumvent the hurdles set up by opponents by travelling to other countries, the faster these obstacles will fall and support more liberal regulations. Clever institutions and authorities will not allow themselves to be drawn into disputes that they can only lose despite high legal costs. The condemnation of dying with the Sarco will not last long. Too many will want to choose this particular route.

And finally: how human is the support provided in preparation for the Sarco. For example, the gift of being allowed to set up the Sarco on private property. Or after a toast with a glass of wine to say goodbye. Perhaps after a meal together and a last tearful hug. It is precisely the help of other people who do not want to impose their own values on the last farewell that can give this death a special dignity.

Basler Zeitung

The Schaffhausen public prosecutor’s office is investigating the first death in the death capsule. Research shows that they are taking an unusually tough approach – and are sticking to a dubious theory.

Brief overview:

• On 23. September 2024, a person died in the Sarco suicide capsule for the first time.
• On the same day, the Schaffhausen police arrested four people.
• Florian Willet, the director of The Last Resort, the euthanasia organization behind Sarco, was held in custody for ten weeks.

The story of the Sarco suicide capsule takes another unexpected turn. At the beginning of this week, the phone of a journalist from this editorial team rings: it’s Florian Willet, the director of The Last Resort. The new euthanasia organization in Switzerland that is behind Sarco. Willet is in hospital and asks for a personal interview.

At the moment, he does not wish to comment publicly on Sarco or his state of health. But what has happened over the last few months seems to have taken its toll on the 47-year-old’s health. Out of respect for his privacy, this editorial team will not go into further detail about the hospital visit.

Willet was the only person present when a person committed assisted suicide in the capsule for the first time in Schaffhausen in September. He then spent ten weeks in custody before being released on 2. December. The investigation against him is still ongoing.

But what has happened in the last few months? Why was Willet held in custody for so long?

This editorial team spoke to those involved and independent experts from the judiciary and forensic medicine and was able to inspect important documents. The picture that emerges is of a public prosecutor’s office taking a hard line – and clinging to a strangulation theory about which there are considerable doubts.

An iPad becomes a piece of evidence
Monday afternoon, 23. September 2024, it’s just before 4 p.m. Florian Willet stands quietly and looks at the iPad in his hand. He taps on the screen, opens an app and follows a flashing graphic with his index finger. He takes out his cell phone and films the screen. Then he looks up from his iPad at what he has been working towards for a long time: the Sarco.

A few minutes ago, a seriously ill American woman climbed into the dark blue suicide capsule. It is located in a piece of forest in Merishausen in the canton of Schaffhausen. The capsule is sealed airtight and nitrogen is flowing into the Sarco. The woman will be dead any moment.

Willet is the only person present at the first assisted suicide using a death capsule. This is confirmed by video footage that this editorial team was able to view. They show him walking around the capsule with the iPad for a good 20 minutes. In between, he calls Sarco inventor and euthanasia activist Philip Nitschke and reports back. He also sends him the cell phone videos. These are not just for documentation purposes – they become an essential piece of evidence.

At 4.01 p.m. the woman is dead.

Willet was in custody for ten weeks
The pictures from the forest in Schaffhausen went around the world just hours later. A mixture of astonishment and disbelief gripped Switzerland. Because on that Monday afternoon, those responsible at Sarco ignored all warnings from the authorities. Various public prosecutors had previously threatened to open criminal proceedings in the event of a Sarco operation in their canton. Including the Schaffhausen prosecutors.

They arrested four people on the spot: In addition to Willet, these were two lawyers mandated by The Last Resort and a Dutch photographer. The latter was not present during the suicide, but was in the vicinity.

Willet, a German citizen residing in Switzerland, then had to spend a whole ten weeks in custody before being released on 2. December. The reason: the public prosecutor suspected him of premeditated murder. This charge is much more serious than the suspicion of incitement and assisted suicide, which the Schaffhausen authorities initially communicated.

As the newspaper “de Volkskrant” revealed, investigators are looking into whether Willet strangled the deceased. The Dutch medium covered the Sarco premiere, including with a photographer. Because the suspicion of murder was “urgent” according to the public prosecutor’s office, the investigators kept Willet in custody. Although the suspicion is no longer “urgent”, it is still there, as First Public Prosecutor Peter Sticher confirmed on request.

Where does this theory come from? And is the action taken by the public prosecutor’s office justified?

“No interest”, public prosecutor’s office waives medical records
As surprising as the Sarco premiere in Schaffhausen was for the public, the local authorities had long been aware of the project. This is shown by a written exchange that this editorial team was able to view. It began at the end of May through Exit International, an euthanasia organization backed by Australian activist Philip Nitschke. It has nothing to do with the euthanasia organization of the same name established in Switzerland. Exit International pulls the strings in the background, while The Last Resort then goes public.

Those responsible at Sarco announced to the Schaffhausen public prosecutor’s office and the cantonal doctor that they wanted to carry out the first assisted suicide in a capsule in their canton. First Public Prosecutor Sticher then writes back. He announces a “critical investigation” and threatens criminal proceedings.

The plans are leaked. On 3. July, the NZZ reports that Sarco is likely to be deployed in the same month.

On 8. July, Sticher’s subordinate and senior public prosecutor (name known to the editors) telephones a lawyer from Exit International. He offers to send the public prosecutor’s office a comprehensive dossier. It contains the medical records of the American woman who wanted to die, proof of her capacity and a letter from her two sons accepting her wish to commit suicide.

According to a note in the file, the lead prosecutor makes it clear that he is very critical of Sarco. He did not want to see the documentation in advance. In any case, the canton of Schaffhausen had “no interest whatsoever in Exit International providing end-of-life care in the canton of Schaffhausen, let alone opening a house for the dying”. However, a home for the dying was never an issue.

The public prosecutor’s office will not tell this editorial team why it rejected the dossier.

iPad documents oxygen content in the capsule
So on 23. September at 4.01 pm, the time has come. The 64-year-old American woman, who suffers from a serious immune deficiency, is the first person to die in the Sarco. According to Nitschke, he followed the assisted suicide via camera in the capsule. “It looked exactly as we expected,” Nitschke told the media afterwards. He was able to track the oxygen content in the capsule.

Via the aforementioned app on Florian Willet’s iPad. The graphic shows the progression of the oxygen content in the capsule. This is shown by video recordings that this editorial team was able to view. The time information is particularly important. It shows that the oxygen content in the capsule was below 10 percent for at least 26 minutes. Until well after 4 pm. If the oxygen content is this low, a person dies after just a few minutes.

This means that the capsule could not have been opened during this time. Otherwise the oxygen content would have shot up due to the incoming outside air.

Willet stays put. The two lawyers and the Dutch photographer are nearby when one of the lawyers calls the public prosecutor’s office at around 4.40 pm. He informs them of the suicide. But nobody turns up. So the lawyer calls a second time shortly before 6 pm. Then the police show up with a large contingent, arrest all four of them and confiscate the suicide capsule. The deceased is taken to the Institute of Forensic Medicine at the University of Zurich.

The strangulation theory
Although Willet “surrendered” to the police, the public prosecutor still suspects that Willet may have deliberately killed the woman. This also raises questions because the prosecutors must be in possession of the video recordings and Willet’s iPad and cell phone. The “Volkskrant” did address the fact that there were interruptions in the video recordings – because the camera only filmed when there was movement. However, the recordings from the outside camera only stopped after 4.30 p.m., when the woman was already dead.

The suspicion of intentional homicide is based on a telephone conversation with a person from the Institute of Forensic Medicine. According to a telephone memo, she informed the public prosecutor’s office of the findings a few hours later.

Among other things, injuries were found on the woman’s neck. These could have been caused by a spasm. However, the findings were more likely to indicate “blunt force to the neck”. To date, the public prosecutor’s office has not received an autopsy report that would discuss the suspicion in more detail.

The video recordings and the oxygen measurement speak against a violent approach by Willet. No traces of Willet’s DNA were found on the body of the deceased. In any case, Willet surrendered to the police, which according to legal experts makes it highly unlikely that he could have strangled the woman.

Ulrich Zollinger is a professor emeritus of forensic medicine. He has investigated numerous unusual deaths, including deceased people who died with the established Swiss exit organization. “In my 30 years, I have never discovered anything unusual that would have made a post-mortem necessary.” On the other hand, he can understand why people are taking a closer look at Sarco “because of the topicality and explosive nature of the first application”. But precisely because the case was so interesting and had resulted in a lengthy period of pre-trial detention, he could not understand why no post-mortem report had been submitted for so long.

Zollinger is sceptical about the suspicion of strangulation. “I can’t imagine that an assisted dying person would want to and be able to cause death in this way.” In addition, there would have been video footage of the place of death after the woman got into the Sarco. “If someone had helped, this would have been recorded.”

Bernhard Rütsche, a professor of public law at the University of Lucerne, finds the suspicion “difficult to understand”. He has already published several articles on euthanasia and says: “The suspicion, which is apparently based on a phone call, seems to be a pretext.” In order to justify a ten-week pre-trial detention, a partial forensic report or other solid evidence would have to be available.

The public prosecutor’s office also refused to question Philip Nitschke. Although, according to The Last Resort, he was the only person who was in direct contact with Willet during the first Sarco operation – and could therefore potentially provide information relevant to the investigation.

Unusual methods
Not even the defendants’ lawyers know what evidence the public prosecutor’s office has. To date, they have not been granted access to the files, although they have requested it several times. It is common practice that evidence is initially withheld from the defence until the accused has been questioned about it. But Rütsche calls it “highly unusual” that the lawyers have still not been granted access.

He suspects that the public prosecutor’s office wants to set an example. “They may be under pressure to crack down on this form of assisted suicide.”

This is not the first time that the public prosecutors involved have been criticized for unusual methods. The leading public prosecutor in Schaffhausen has a controversial history from his time as a public prosecutor in Thurgau. He led the proceedings in the so-called Kümmertshausen case, the largest criminal trial ever in Thurgau. It involved a homicide, human trafficking, gang crime and much more. However, the Federal Supreme Court removed him and a colleague from the investigation in 2015 – due to “numerous and in some cases blatant procedural errors”. They were subsequently tried for multiple counts of abuse of office and falsification of documents, but were acquitted in 2023.

The Schaffhausen public prosecutor’s office leaves an extensive list of questions unanswered. And invokes official and investigative secrecy.

AP News

Swiss prosecutors said a right-to-die activist was released Monday after more than two months in police custody over the reported first use of a so-called “suicide capsule,” after they ruled out the possibility of an intentional homicide.

Florian Willet, head of advocacy group The Last Resort, was released by authorities in the northern Schaffhausen region, where a 64-year-old U.S. woman in late September was said to be the first user of the Sarco suicide capsule, a sealed chamber that releases gas at the press of a button.

Authorities detained four people, but initially only released three of them — holding Willet on suspicion that the woman, who was not identified, might not have committed suicide but could have been killed.

A statement Monday from prosecutors said a criminal case was opened on Sept. 23, the day of the woman’s death, for suspected “inciting and abetting suicide” and a “strong suspicion of the commission of an intentional homicide.”

Although an autopsy report from experts in neighboring Zurich was not yet available, investigators no longer suspect intentional homicide, though there is “strong suspicion of the crime of inciting and abetting suicide,” the statement said.

The statement said the suspect was released from custody though it didn’t identify the suspect by name. Willet previously has spoken repeatedly to The Associated Press before his arrest and his colleagues have spoken out publicly in his defense in hopes of securing his release.

Prosecutors gave no further details, including whether the suspect was released conditionally and faced a continued criminal investigation over suspected incitement of suicide.

Calls by The AP to Willet’s mobile phone were not immediately answered.

Sarco developer Philip Nitschke of Exit International, a right-to-die group affiliated with The Last Resort, has said the allegations that the woman might have been strangled were “absurd. Nitschke said he watched by video during the woman’s death, in a wood in the Schaffhausen region near the German border, and that the device worked as planned.

The Sarco was designed to allow a person sitting in its reclining seat to push a button that injects nitrogen gas into the sealed chamber. The person is then supposed to fall unconscious and die by suffocation in a few minutes.

Swiss law allows assisted suicide so long as the person takes his or her life with no “external assistance” and those who help the person die do not do so for “any self-serving motive,” says a government website.

Switzerland is among the only countries where foreigners can travel to legally end their lives and has a number of organizations that are dedicated to helping people kill themselves.

Nitschke has repeatedly said Exit International’s Swiss lawyers had advised that use of the capsule would be legal in Switzerland.

Suicide capsule inventor Philip Nitschke talks about the Sarco premiere for the first time. He considers the criminal proceedings for intentional homicide to be absurd. In this interview, Nitschke tells us what he is planning next.

By Simon Hehli NZZ

Mr Nitschke, on 23 September, a woman died for the first time in your suicide capsule Sarco. Did you feel a sense of triumph?

No, rather a feeling of relief that the Sarco, in which we had invested so much work, worked as planned. Just as we had predicted on a scientific basis. Above all, I was happy that the woman was able to have the peaceful death she had wished for. There were discussions as to whether death by asphyxiation with nitrogen is really so peaceful and quick. Also because of the experience with the execution in Alabama.

In January, a murderer was executed there with nitrogen for the first time. Before he died, he jerked violently and gasped for air.

I travelled to the USA before the execution and tried to convince the authorities to stop the whole thing. Unfortunately without success. It is a completely different matter whether someone voluntarily lies down in the Sarco or whether a condemned person resists the execution. Because the nitrogen mask has slipped, with all the terrible consequences that entails.

Who was the American woman who died in the Sarco? What were her motives?

She was one of the people who contacted us after we publicised our plans for Sarco in Switzerland. I was not involved in choosing this woman as the first Sarco user, but I looked at her health records. She had so many medical problems. I fully understood her rational decision to end her suffering. That’s all I want to say about her.

Are you now so reluctant to provide information because you have been accused of putting on a media circus and parading the Sarco users, instrumentalising them?

No, but her person and her motives have been somewhat overshadowed by all the unbelievable things that happened after her death.

You mention the proceedings against your fellow campaigner Florian Willet. Why weren’t you in the forest in Schaffhausen yourself during the Sarco premiere?

I installed the Sarco on site and tested it for several days. But I couldn’t be there on 23 September. I had to give a lecture in Budapest and therefore had to be back in Amsterdam in time. But of course I followed everything from afar. Florian knew what to do. He didn’t need me there.

Wasn’t it mainly about evading the Swiss authorities?

We had intensive discussions with our lawyers before 23 September. Their advice was that several people from our organisation should not be present on site at the same time. From a legal point of view, it made sense for Florian to take on the role, partly because he lives in Switzerland, is a lawyer and managing director of our Swiss branch, The Last Resort.

Willet has been in custody for more than seven weeks. Were you surprised at how rigorously the Schaffhausen judiciary is taking action against your organisation?

To say I was surprised would be a complete understatement. I am perplexed and deeply disturbed by what is happening here. We knew there would be an investigation, that’s standard practice. But we were and are convinced that everything we do is in full compliance with Swiss law, so we were relaxed about it. But when rumours emerged that the Schaffhausen public prosecutor’s office was investigating on suspicion of intentional homicide, I was horrified.

Strangulation marks were said to have been found on the American woman’s neck.

Absurd! This is allegedly the result of a telephone note at the time of the autopsy. However, an autopsy report is still not available today. I cannot understand why such a report should not be available after more than fifty days. And this while Florian is in custody. In addition, the public prosecutor’s office apparently has documents according to which no DNA from Florian was found in the neck area of the deceased.

What happened in those minutes that you watched from afar?

I was able to see everything live through the cameras we had installed inside and outside the Sarco. I heard the conversations between Florian and the woman. I also monitored the oxygen levels in the capsule. Everything happened exactly as we had predicted. The woman got into the Sarco alone, closed the lid without help and pressed the button that released the nitrogen on her own. She lost consciousness and died after about six minutes.

There are rumours that the Sarco did not work as planned. It is therefore only a small step to speculating that Willet may have assisted in the woman’s death.

I don’t know who starts such rumours. There is not the slightest indication of such a scenario. From the time the woman got into the Sarco until the police arrived, nobody opened the lid. We documented everything, including the oxygen content in the capsule, which was always at a lethal level.

The public prosecutor’s office is apparently accusing you of not co-operating.

That’s not true. Me and my wife wanted to come to Switzerland from the beginning to make a statement. The public prosecutor’s office refused.

But your office in Harlem was searched.

Yes, the Dutch police came by, probably on behalf of the Swiss authorities. I didn’t even get a list of the things they took – including a model of the Sarco.

A second accusation is that you are offering suicide by Sarco for selfish reasons – for example, to enrich yourself.

I am an activist and I want the world to be a better place. That’s what I’ve been doing for thirty years. It’s not about making a profit with Sarco and there is no business model behind it. Fortunately, we have enough money – also to continue developing the Sarco.

How much has the development and production of the Sarco cost so far?

Almost a million dollars. There is a lot of technical innovation in the capsule, we have been working on it for almost ten years. And there have been a few setbacks along the way.

Where does all this money come from?

From donations. There are many people who can see what a step forward the Sarco is. It makes euthanasia so much easier.

Will the use of the Sarco always be free, apart from the few francs for the nitrogen?

Yes, this is also an ethical question. We are convinced that you shouldn’t charge money for an assisted death. Especially when you realise that it is already very expensive for foreigners who wish to die to travel to Switzerland.

You are thus challenging the Swiss euthanasia organisations, whose business model is to charge foreigners around CHF 10,000 for their services. Is that why you accused these organisations of plotting against you?

I am very disappointed at how little openness euthanasia organisations have towards new technologies – and not just in Switzerland. I’ve only heard silly arguments against Sarco. For example, that nobody wants to die isolated from the world. That’s simply not true, otherwise hundreds of interested parties wouldn’t have contacted us. It’s a gain if there is freedom of choice in assisted suicide.

Anyone who talks to local euthanasia activists will hear another accusation levelled at you: that you want to make means of suicide easily accessible to everyone – including young, depressed people who act on impulse. Is that your aim?

Anyone who makes such a claim has clearly misunderstood our motives and ambitions. We abide by Swiss law – and it rightly stipulates that someone who wants to make use of euthanasia must be capable of judgement. An 18-year-old who is lovesick is obviously not a Sarco candidate. As stated on The Last Resort’s website, only people aged 50 and over are eligible for Sarco.

The accusation also stems from the fact that you published the book ‘The Peaceful Pill’ – in which you describe various suicide methods in detail.

I wrote the book for the members of our organisation Exit International. They are on average 75 years old. There is a great need among older people for information on assisted suicide, and they have every right to receive this information. Many of our members have a lethal dose of pentobarbital in their cupboard and know how to use it thanks to the book. This gives them great peace of mind. It was never my intention that young people would misuse the information to kill themselves. Anyone who wants to buy my book must therefore prove by video and ID that he or she is at least 50 years old.

One of your main arguments in favour of the Sarco is that it eliminates doctors as the authority who have to prescribe the pentobarbital. Why is that so important to you?

The Swiss model is so much better than the regulations in most countries around the world. I have been repeating this for years when I travel the world and speak to parliamentary committees. I tell them: Take a leaf out of Switzerland’s book.

But?

The problem is that in Switzerland, too, someone judges whether another person is suffering enough to be allowed to die. Doctors take on this judgement role. That is an imposition. Doctors are often overly critical of euthanasia. No, the decision must lie with the person concerned, not with some gatekeeper. Sarco makes this possible.

The Swiss euthanasia organisations say that it is not a major problem to obtain the lethal pentobarbital.

According to the current rules of the Swiss Medical Association, only those who are so ill that they are ‘suffering unbearably’ should receive euthanasia. A few years ago, the well-known Australian botanist David Goodall wanted to die in Switzerland. The man was 104 years old and simply tired of living. He should have pretended to be ill. But he understandably refused. It was not so easy for him to find a doctor who would help him anyway.

Do you not understand the fears that Sarco would further boost ‘death tourism’ in Switzerland?

I don’t think the situation would change much. Many people already come to Switzerland today and are grateful for the progressive rules. You Swiss should be proud of that! Look at the UK, for example, I’m following the debate there very closely. There is to be a new euthanasia law. It will be so restrictive that many Britons will still feel compelled to travel to Switzerland to die.

But it is precisely these liberal rules that could now be jeopardised because of all the fuss surrounding Sarco – because some politicians feel compelled to regulate euthanasia more strictly.

I’m not particularly impressed by that argument. It could be used to oppose any innovation: Why should we change anything? We’ve made ourselves comfortable. But the current solution is not ideal for people who are looking for help with dying. That’s why Sarco is needed. It seems as if Switzerland has suddenly become afraid of its liberal legislation and its pioneering role worldwide.

Have you underestimated how critically Swiss politicians view your capsule? Interior Minister Elisabeth Baume-Schneider said that its use was not legally compliant – pretty much at the very moment you used the Sarco for the first time.

I have no idea how Mrs Baume-Schneider arrives at such an assessment. It contradicts all the opinions of Swiss lawyers that we have obtained. And also from professors who spoke out after the Sarco premiere. Of course, we hadn’t planned for the first deployment to take place at the exact moment when the minister responsible was making a statement about Sarco. That was an unfortunate coincidence.

The serious allegations made against you by Jennifer McLaughlin also caused a stir. The woman who should have been the first to die at Sarco called you and your fellow campaigners ‘heartless people’ and said that you were only interested in generating public attention. How did this break come about?

It was a mistake that we chose her first, I wish we had realised that earlier. She had serious mental health problems, and I have experienced episodes of this myself. I firmly reject your accusations, they are demonstrably untrue. That is why your newspaper corrected these accusations, at least in part.

Before McLaughlin died at a Swiss euthanasia organisation, a psychiatrist stated in an expert opinion that she was of sound mind. Are you accusing him of negligence?

No. But unlike me, he didn’t have the opportunity to accompany Jennifer over a longer period of time. I’ve been a doctor long enough to know that an assessment of a patient’s mental state also depends on how they are feeling on the day.

You implicitly say that the Swiss organisation broke the rules by helping a mentally ill woman to commit suicide. That’s a strong accusation.

They can do what they like, it’s none of my business. I’m just glad that the woman didn’t die in the Sarco.

The question now is whether and when the Sarco will be used again. Will you wait until the proceedings against Florian Willet are over?

Yes, definitely. We want a clear decision from the judiciary before we bring Sarco number two, which is currently in production, to Switzerland. Sarco number one, with all its innovative software, is still confiscated. The investigations can only have one outcome: that the Sarco does not violate any Swiss law.

The legal proceedings could take months or even years. Are you looking around for alternatives to Switzerland?

I hope it will be quick. But there are other places where we could take Sarco. For example, to Finland, where, according to our lawyers, there is no specific law prohibiting assisted suicide. Another possibility is for people who want to die to produce the Sarco themselves in a 3D printer, get in and press the button. No country in the world can prohibit people from committing suicide.

Police in northern Switzerland said Tuesday that several people have been detained and a criminal case opened in connection with the suspected death of a person in a “suicide capsule.”

The “Sarco” capsule, which has never been used before, is presumably designed to allow a person sitting in a reclining seat inside to push a button that injects nitrogen gas into the sealed chamber. The person is then supposed to fall asleep and die by suffocation in a few minutes.

Exit International, an assisted suicide group based in the Netherlands, said it is behind the 3D-printed device that cost over $1 million to develop.

Swiss law allows assisted suicide so long as the person takes his or her life with no “external assistance” and those who help the person die do not do so for “any self-serving motive,” according to a government website.

A law firm informed prosecutors in Schaffhausen canton that an “assisted suicide” involving the Sarco had taken place Monday near a forest cabin in Merishausen, regional police said in a statement, adding that “several people” were taken into custody and prosecutors opened an investigation on suspicion of incitement and accessory to suicide.

Dutch newspaper Volkskrant reported Tuesday that police had detained one of its photographers who wanted to take pictures of the use of the Sarco. It said Schaffhausen police had indicated the photographer was being held at a police station but declined to give a further explanation.

The newspaper declined to comment further when contacted by the Associated Press.

Schaffhausen’s public prosecutor Peter Sticher told Swiss newspaper Blick that several people were arrested “so that they were not colluding with each other or covering up evidence.”

Sticher said the operators knew the risks of being arrested.

“We warned them in writing. We said that if they came to Schaffhausen and used Sarco, they would face criminal consequences,” he said.

In an email, the Dutch Foreign Ministry told the AP that it was in contact with the newspaper and Swiss officials.

“As always, we cannot interfere in the legal process of another country. At the same time, the Netherlands stands firmly for press freedom. It is very important that journalists worldwide can do their work freely,” it said.

Exit International, the group behind the Sarco, said in a statement a 64-year-old woman from the U.S. Midwest – it did not specify further – who had suffered from “severe immune compromise” had died Monday afternoon near the German border using the Sarco device.

It said Florian Willet, co-president of The Last Resort, a Swiss affiliate of Exit International, was the only person present and described her death as “peaceful, fast and dignified.”

Dr. Philip Nitschke, an Australian-born trained doctor behind Exit International, has previously told the AP that his organization received advice from lawyers in Switzerland that the use of the Sarco would be legal in the country.

In the Exit International statement on Tuesday, Nitschke said he was “pleased that the Sarco had performed exactly as it had been designed … to provide an elective, non-drug, peaceful death at the time of the person’s choosing.”

The claims of Nitschke and Exit International could not be independently verified.

On Monday, Health Minister Elisabeth Baume-Schneider was asked in Swiss parliament about the legal conditions for the use of the Sarco capsule, and suggested its use would not be legal.

“On one hand, it does not fulfill the demands of the product safety law, and as such, must not be brought into circulation,” she said. “On the other hand, the corresponding use of nitrogen is not compatible with the article on purpose in the chemicals law.”

“Not legally compliant”
In July, Blick reported that Sticher, the state prosecutor in Schaffhausen, wrote to Exit International’s lawyers saying any operator of the suicide capsule could face criminal proceedings if it was used there – and any conviction could bring up to five years in prison.

Prosecutors in other Swiss regions have also indicated that the use of the suicide capsule could lead to prosecution.

Over the summer, a 54-year-old U.S. woman with multiple health ailments had planned to be the first person to use the device, but those plans were abandoned.

Switzerland is among the only countries in the world where foreigners can travel to legally end their lives and has a number of organizations that are dedicated to helping people end their lives. But unlike others, including the Netherlands, Switzerland does not allow euthanasia, which involves healthcare practitioners killing patients with a lethal injection at their request and in specific circumstances.

About 1,300 people died by assisted suicide in Switzerland in 2020, the BBC reported.

Some lawmakers in Switzerland have argued that the law is unclear and have sought to close what they call legal loopholes.

Interior Minister Baume-Schneider, taking questions in parliament on Monday, said: “The Sarco suicide capsule is not legally compliant.”

“Firstly, it does not meet the requirements of product safety law and therefore cannot be placed on the market. Secondly, the corresponding use of nitrogen is not compatible with the purpose article of the Chemicals Act,” she said.

Fiona Stewart, who is on The Last Resort’s advisory board, said the group was acting on legal advice, which “since 2021 has consistently found that the use of Sarco in Switzerland would be lawful.”

In 2021, Daniel Huerlimann, a legal expert and assistant professor at the University of St Gallen, was asked by Sarco to explore whether the use of the suicide pod would break any Swiss laws.

He told the BBC that his findings suggested the pod “did not constitute a medical device,” so would not be covered by the Swiss Therapeutic Products Act.

He also believed it would not fall foul of laws governing the use of nitrogen, weapons or product safety, the BBC reported.

“This means that the pod is not covered by Swiss law,” he said.

CBS News 24 September 2024

In Switzerland on Monday, a 64-year-old woman died in a specially designed ‘suicide capsule’ containing nitrogen gas. It is the first time ever that this suicide capsule, called the Sarco, was used. The capsule, an airtight cabin the size of a coffin, offers, according to its creators, a ‘quick, peaceful and reliable death’ without the assistance of a doctor or medication.

The 64-year-old woman looks at the Sarco, well before the moment she will enter the capsule.

The woman’s death was confirmed by physician Philip Nitschke, creator of the capsule and an internationally known advocate of the right to die movement.

The American woman, who traveled to Switzerland for this purpose, initiated her dying process herself by pressing a button while lying in the capsule. The air in the cabin was then rapidly replaced by nitrogen gas, causing the oxygen level to drop to a deadly level within a minute. Nitrogen is not poisonous. The woman lost consciousness and died of hypoxia, the lack of oxygen, says the organization that accompanied her.

Arrests after the suicide
The police of Schaffhausen, the Swiss canton in which the suicide took place, detained a Volkskrant photographer on Monday who followed the case closely and wanted to take photos. The newspaper was unable to contact the photographer for hours. Late Monday evening, police in Schaffhausen confirmed that the photographer was being held at the police station. The police did not want to provide any further explanation.

The police may also have detained director Florian Willet of the Swiss organization The Last Resort, who was present at the suicide. Swiss police declined to comment on Tuesday morning, only confirming that police had carried out an ‘operation’ near Schaffhausen the day before.

The right to die movement
The Sarco was designed and built in the Netherlands. Creator Nitschke (77), an Australian doctor and physicist who lived in the Netherlands for the past ten years, has worked on the development of the capsule for twelve years. Nitschke is the founder of Exit International, a movement with 30,000 members who are searching for the best methods for a dignified, self-chosen death. This is difficult, because ‘humane’, deadly drugs are very hard to obtain. The woman’s death is an important step for the right to die movement, according to Nitschke.

Nitschke has tested his capsule several times. In May he lay down in the capsule filled with nitrogen gas for five minutes with an oxygen mask on his face, as seen by de Volkskrant.

More elegant variant
According to Nitschke, his invention is a more elegant variant of people who kill themselves using gas in a bag over their head. He says death in the Sarco is similar to the death that follows when cabin pressure is lost in an airplane and passengers are left without oxygen. ‘We know from people who have survived that this doesn’t feel like suffocating’, he says. ‘You just keep on breathing. After half a minute people start to feel disoriented. They’re not really being aware of what is happening to them. This is often accompanied by a feeling of mild euphoria. And then they just slip away.’

The 64-year-old woman died at an estimated time of 4:01 PM in the afternoon in the Sarco, says Nitschke. She was in the presence of Florian Willet, the director of The Last Resort, a Swiss assisted suicide organization that supervised the procedure. He was the only person present at her death.

The Last Resort was founded in July 2023 in Switzerland specifically for the use of the Sarco. According to the organization, a good death is a ‘fundamental human right’. The Last Resort chose Switzerland as its base because it is one of the few countries in the world where assisted suicide is permitted under certain conditions. In the Netherlands this is illegal.

‘She really wanted to die’
Nitschke, who is technical advisor to The Last Resort, followed the death of the woman from Germany, via an oxygen and a heart rate monitor and a camera in the Sarco. The dying process went ‘well’, he said to de Volkskrant. ‘When she entered the Sarco, she almost immediately pressed the button. She didn’t say anything. She really wanted to die. My estimate is that she lost consciousness within 2 minutes and that she died after five minutes. We saw jerky, small twitches of the muscles in her arms, but she was probably already unconscious by then. It looked exactly how we expected it to look.’

The Sarco was set up outside in a remote area in Switzerland, near the German border. Through a window the woman had a view of nature during her last moments. She could see the sky and the trees that surrounded the capsule. After her death, The Last Resort informed the Swiss police.

Rules of the Chemicals Act
Until recently, the Swiss government did not comment on whether the Sarco is legal. Supervising authority Swissmedic stated that the Sarco is not a medical device, so therefore no permit is required. Moreover, nitrogen, a gas that is present in the air, is not registered as a medicine. On Monday however, Swiss Minister of Internal Affairs Elisabeth Baume-Schneider stated that, in her opinion, the Sarco would not meet product safety requirements and that nitrogen in the Sarco does not meet the rules of the Chemicals Act, writes Swiss newspaper NZZ.

Before using the Sarco the American woman made an oral statement to lawyer Fiona Stewart, one of the directors of The Last Resort. Stewart is also Nitschke’s wife. The statement was listened to by de Volkskrant, with her permission.

Serious illness and severe pain
In the recording, which lasts just over four minutes, the woman confirms that it was her own wish to die. She says that she has had a desire to die for ‘at least two years’, ever since she was diagnosed with a very serious illness that causes severe pain. She also states that her two sons ‘completely agree’ that this is her decision. ‘They support me 100 percent’, she said. Stewart from The Last Resort says both sons also confirmed this through written statements to The Last Resort. The sons were not present in Switzerland.

The American woman was examined in advance by a psychiatrist, who deemed her competent, says Stewart. ‘When she registered, she said that she would like to die as quickly as possible.’ According to her the woman did not have a psychiatric history.

‘Dr. Death’
Nitschke’s actions often sparked heated debates in the past. Some journalists nicknamed him ‘Dr Death’. In 2006, he caused a worldwide stir with a book in which he describes dozens of suicide methods in detail: The Peaceful Pill Handbook. Due to the fuss about his activities, he moved to the Netherlands ten years ago.

He announced his latest invention, the Sarco, in the Huffington Post with the words: ‘What if we dared to imagine that our last day on this planet might also be one of our most exciting?’

‘The day you die is one of the most important days of your life’, Nitschke says to de Volkskrant. ‘When it becomes inevitable, why don’t we embrace it? With this machine you can die anywhere you want: with a view of the mountains or of the waves of the ocean. And apart from this device, you don’t need much: no doctor putting a needle into your veins, no illegal drugs that are difficult to obtain. This demedicalizes death.’

‘Free to use’
It is still unclear how Swiss justice will react to this. The conditions set by the country are that the person with the death wish is mentally competent, that they carry out the final deadly act themselves and that the people who help have altruistic motives.

According to The Last Resort, the woman paid nothing for the Sarco, with the exception of 18 Swiss francs for the nitrogen tank and her funeral costs. ‘Using the Sarco is free’, Stewart states. ‘That is part of our philosophy. We don’t want to make any money on this. ‘

3D printers
There are several organizations in Switzerland that help people die. This is done with the help of doctors. Every year, hundreds of foreigners travel to the country for this purpose – and their number is growing. Critics refer to this as ‘suicide tourism’. The Last Resort sharply criticizes the high amounts charged by these organizations. ‘There is no moral mandate to charge 10,000 Swiss francs plus for assistance in a peaceful and reliable suicide’, they say on their website.

The Sarco was manufactured with the help of 3D printers. Creator Philip Nitschke plans to publish the blueprints in his handbook. The Last Resort also wants to open the suicide capsule to others in the future. They already have a waiting list, Stewart says. One of the conditions will be that people are over 50. ‘This is not for young people’, Stewart says. ‘We don’t want to encourage suicide.’

deVolkskrant 24 September 2024

The Sarco is a multi-faceted R&D project of Exit International.

There are 4 principal components to Sarco Project. Apart from the game-changing 3D printing of the enclosed euthanasia capsule, the Sarco project incorporates research questions involving Sarco Raspberry Pi software to allow entry access, the development of mental capacity screening using AI and, finally, the concept of an implantable dementia switch.

1. Sarco Raspberry Pi & the Development of AI Screening

The Sarco project incorporates experimental software developments.

In this regard, Raspberry Pi processor will allow a series of mandatory questions to be asked of the user of the Sarco, before they activate it for use (and for their ultimate death).

A series of questions will be asked verbally. Only upon the correct responses being recorded will the green ‘Go’ button be able to be pushed and the Sarco acvitated by the user (inside).

The questions to be answered are:

• What is your name
• Where are you?
• What will happen when you press the activation button inside Sarco?

The final question is: ‘Do you wish to proceed?’

If this final question records a ‘yes’ answer, the user will be able to push the green ‘go’ button and activate the Sarco.

This is the activation procedure for the Sarco and is already part of Sarco 3.0.

2. AI Mental Capacity Screening: Is this the Future?

In Switzerland, assisted suicide is allowed as long as the person being assisted possesses mental capacity.

At the current time, mental capacity is determined by a psychiatric assessment by a registered psychiatrist.

The Sarco project wants to challenge this status quo using AI.

The research question driving this part of the Sarco project is, ‘is AI better at mental capacity assessment than a real life psychiatrist?’

The role of AI in the determination of mental capacity remains controversial, even though there is growing evidence that current human assessment is subject to bias and an inability to replicate results.

A recent summary of the Sarco Project in MIT Technology Review referred to a “messy morality” of letting AI make life and death decisions.

This article can be read on the Exit International Website.

3. The Development of an Implantable Dementia Switch?

The Sarco R&D project also incorporates the objective of creating an implantable switch which could be activated by the person in whose body it is implanted, in the face of mental decline due to dementia and Alzheimer’s.

At the current time, the only strategy (at least in the Netherlands) on offer to give agency (in terms of end of life decision-making) back to those suffering dementia and Alzheimer’s, is an advance health directive.

In most jurisdictions, however, not even this is available. People with a cognitive mental health diagnosis tend to be excluded from most legislative models. This is a deeply unsatisfactory and cruel state of affairs.

To address this need, Exit has set about to create a programmable, implantable switch.

In theory, this switch would be continuously maintained by a user as a normal function of their continuing mental capacity.

However, if the switch failed to be maintained by its owner, again in theory, the switch could instigate an action that could cause death.

A thought experiment has been created by Marije de Haas. This work has inspired Exit’s thinking and commitment to find a technological solution to this intractable problem.

Sarco goes to Login 2023 @ Vilnius, Lithuania (May 2023)

In May 2023, Philip Nitschke presented a keynote address at the future tech conference Login2023 in Vilnius, Lithuania.

As soon as this presentation is available online, the link shall be posted here.

 

 

 

Sarco Project – August 2022 Update

The Sarco Project is an integrated plan to use new technologies to alter the experience of death. The goal is to place the person who wishes to die center stage with unrestricted control of the process. In particular the project aims to remove any need for any specialized or medical involvement.

There are several components to the Project:

•  Construction of a 3D printed Sarco to provides a peaceful hypoxic death
• Programming of Sarco Raspberry Pi software to allow access to the machine
• Development of AI screening to ensure those seeking access have mental capacity.
• Development of an implantable switch for those anticipating mental capacity loss.

This update provides information on the current state of each of these components.

• Construction of the 3D printed Sarco

Sarco#1 and Sarco #2 have been 3D printed but are non-functioning. Sarco #1 will be towed to Geneva on a special trailer in mid September and go on public display as part of OpenEnd 2 “Renegotiation” held @ Cimetiere des Rios opening Thurs Sept 15.

Lessons learnt in the construction of #1 & #2 have been incorporated into the production of Sarco #3 which is the device to be used in Switzerland. Sarco #3 has been printed in Rotterdam and is currently being assembled. Some of the specialised components needed in construction are yet to be delivered – eg the vacuum moulded Perspex canopy and cantilever hinge mechanism. Once assembled the unit will receive professional finishing before being moved to our Hillegom laboratory where instrument testing, imaging using a thermal camera, and gas analysis will take place. This is expected to be completed by late October and the machine will be available for inspection at this time.

• Programming of Sarco Raspberry Pi software to allow access to the machine

Control software that requires the person seeking to use Sarco to answer 3 basic questions before activation has been written for the incorporated Raspberry Pi processor. The questions that need to be answered are 1) Who are you? 2) Where are you? and 3) Do you know what will happen when you press the activation button inside Sarco? Answers are provided verbally and by text and recorded before relay activation of Sarco power takes place. A number of programming errors have delayed completion of this part of the project although this should be resolved by the end of September. •

• Development of AI screening to ensure those seeking access have mental capacity

This is considered an essential part of Sarco Project as it offers the possibility of removing the need for a medical professional to carry out the essential assessment of mental capacity in a person seeking death. The goal is to develop the test that will provide a functioning 4 digit key that will give 24 hours of access to the Sarco startup.

There has been very little support for the concept of AI assessment from the large number of psychiatrists contacted for advice on this project, indeed considerable skepticism has been expressed. Some preliminary programming has begun based on advice from experienced AI developers and some form of elemental screen incorporating a mini mental state cognitive assessment and a set of questions to assess insight will be functioning in 2023.

The absence of this part of Sarco project will not delay the planned use of the device. In the initial stage the assessment of mental capacity will be carried out by the more traditional means, using psychiatric review.

• Development of an implantable switch for those anticipating mental capacity loss.

This part of the project is essential for those who are experiencing a real or expected decline in mental capacity from dementia or other disease. At present the only strategy offered to address this is the completion of a witnessed advance directive that, in some jurisdictions, allows legal assistance to die even for those with no capacity. This is an unsatisfactory solution.

A programmed implantable switch that can be activated while one has capacity and designed to end life after a preset period, unless reset by the owner, offers an important solution. Currently the project has stalled, beset by a number of practical problems.

Two simple strategies are being pursued:

• Programable de-activation of the auto defibrillation function of some implanted pacemakers.
• The use of an implanted RFID chip preset to activate (for example) a Sarco.

During April 2022, Sarco took centre stage in the play, ‘Right to Choose’ at Nowy Theatre in Poznań, Poland.

Directed by Piotr Kruszczyński, Right to Choose is a play by German playwright and lawyer, Ferdinand von Schirach who is perhaps best known for his play, Terror.

Titled Gott in its native German, ‘Right to Choose’ takes as its starting point the decision of the Federal Constitutional Court from February 2020, that everyone has the right to a self-determined death.

With the help of experts, the play’s Ethics Council discusses the question of whether doctors have to fulfill the request of a suicidal patient.

As in Brecht’s Epic Theater, it is said the audience should form an opinion.

This Kruszczyński production is the Polish premiere of the play, which has proven popular in European theaters and TV stations.

The Polish cast include: Bożena Borowska-Kropielnicka, Antonina Choroszy , Marta Herman, Małgorzata Łodej-Stachowiak, Daniela Popławska, Agnieszka Rożańska, Maria Rybarczyk playing the roles of experts standing before the Ethics Committee, with Aleksander Machalica in the main role as the participant in question.

 

The Peaceful Pill eHandbook – 2022 Essentials Edition features a revised Chapter on Sarco that details all the reader needs to know, both now and for the coming year.

The Sarco Chapter answers the criticisms/ questions that have arisen in the mainstream media over recent months. Especially since the story of Sarco’s so-called ‘approval’ in Switzerland went viral in the global media.

The Sarco is an exciting, futuristic project that needs to be contemplated and understood before firm conclusions can be drawn.

In the Peaceful Pill eHandbook – Essentials Edition, one can read how Exit expects the Sarco to be used in Switzerland later this year.

More information about the Sarco can be found at Sarco.design

Read the Sarco Blog

Sarco is now on display in a new exhibition at the Museum for Sepulchral Culture in Kassel Germany until February 2022.

The Museum for Sepulchral Culture is the only independent institution committed exclusively to cultural and scientific standards that deals with the entire spectrum of the so-called ‘Last Things’, and dedicated to the issues of dying, death, burial, mourning and remembrance.

The mission statement of the Musuem is that ‘through enlightenment, consultation and mediation’ in exhibitions etc.there is ‘the opportunity for a conscious examination of death’.

The Exhibition is titled – Suizid: Let’s talk about it

Of this Exhibition, the Museum says:

Suicide and suicidality are common, but kept silent and stigmatized topics in society. The exhibition presents information, suggestions, challenges and opportunities that reflect a social and personal approach to suicide. With a view to the history of art and culture, humanities and social sciences, and medicine, but above all to the here and now, our goal is to promote public communication on suicide

Website: https://www.sepulkralmuseum.de/EN/exhibitions/special-exhibitions

Sarco leaves Venice

The first full-size, 3D-printed Sarco on display in Venice

After two years in development and six months in production, the world’s first fully-3D printed Sarco was on display at Venice Design 2019.

See the gallery

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Watch the picture gallery  of the launch of Sarco in Venice in May 2019

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Sarco arrives in Venice – VIDEO

The 3D-printed euthanasia device – the Sarco – was displayed for the first time at the Amsterdam Funeral Fair at the Westerkerk.

‘Sarco’ is short for sarcophagus.

At the Fair a laser cut wood model was revealed alongside a virtual reality (VR) demonstration which let attendees experience the pod in action.

The Sarco provides death by hypoxia, or low oxygen, and is designed to be portable.

It will come with a built-in detachable coffin and its inventors claim that a fully-functioning version will be built this year, after which the blueprints will be published in the Peaceful Pill eHandbook.

Amsterdam Funeral Fair

Philip Nitschke at Amsterdam Funeral Fair

Alexander Bannink explaining Sarco at the Amsterdam Funeral Fair

 

A full-size, wooden mock-up of Sarco was unveiled at the Amsterdam Funeral Fair on April 14th. 2018

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