While active euthanasia—such as the act of administering a lethal injection to someone who demanded it—remains illegal in Switzerland, supplying the means for committing suicide are legal, as long as the infliction is performed by the one wishing to die. Based on this legal situation, non-profit organisations administering life-ending medicine were first established in the country in the 1980s.
Now, in a controversial move, Switzerland has just legalised a new way of self-infliction by assisted suicide. The country’s medical review board has authorised the use of the Sarco suicide pod, a 3D-printed portable coffin-like capsule with windows that can be transported to a tranquil place for a person’s final breaths of life.
Inventor Philip Nitschke of Exit International told the website SwissInfo.ch that his invention offers a different approach to the ones used until now. “We want to remove any kind of psychiatric review from the process and allow the individual to control the method themselves,” he said. “Our aim is to develop an artificial intelligence screening system to establish the person’s mental capacity. Naturally, there is a lot of scepticism, especially on the part of psychiatrists.”
Approximately 1,300 people have died by assisted suicide in Switzerland in 2020—using the services of the country’s two largest organisations: Exit (which has no connection to Exit International) and Dignitas. Assisted suicide is also legal in the Netherlands, Germany, Belgium, Luxembourg, and Canada. The method currently in use is the ingestion of liquid sodium pentobarbital.
After taking the drug, the patient will fall asleep within two to five minutes before slipping into a deep coma, followed soon afterwards by death. Sarco offers a different approach for a peaceful death, without the need for controlled substances.
Following the concept of assisted suicide, the pod can only be activated from the inside by the person intending to die. To cater to the needs of every patient, the machine can be towed anywhere—be it an idyllic outdoor setting or the premises of an assisted suicide organisation, for example.
The person has to get into the capsule and lie down. “It’s very comfortable,” Nitschke promised. They will then be asked a number of questions and once they have answered them, they’ll be able to press the button inside the capsule activating the mechanism whenever they wish.
The pod is sitting on a piece of equipment that will flood the interior with nitrogen, rapidly reducing the oxygen level from 21 per cent to 1 per cent in just 30 seconds. The person will feel a little disoriented and slightly euphoric before they lose consciousness. Death takes place through hypoxia and hypocapnia, oxygen and carbon dioxide deprivation, respectively. There is no panic, no choking feeling. “In an environment where the oxygen is less than 1 per cent, after losing consciousness death would occur after approximately 5-10 minutes,” Nitschke told SwissInfo.ch.
To qualify to use the pod, the person who wants to die must answer an online survey that is meant to prove whether they are making the decision of their own accord. If they pass, they will be told the location of the pod and given an access code.
In 2020, Exit International sought senior advice on the legality of using Sarco in Switzerland for assisted dying. This review has now been completed and confirmed that the company hadn’t overlooked anything. “There are no legal issues at all,” Nitschke proudly said.
While Exit International created three prototypes of the pod, one was deemed not “aesthetically pleasing” so it won’t be in use. The third Sarco is now being printed in the Netherlands. If all goes well, the third machine should be ready for operation in Switzerland in 2022. The company has not yet announced how much it will cost to use the service.
Understandably, the perception of physician-assisted suicide (PAS) is a highly controversial topic within the medical profession because it centres on the decision of terminating a human life to ease physical and emotional agony. For centuries, issues related to PAS have been debated, with neither advocates nor opponents gaining much ground.
On the one hand, those who favour PAS view the process as a peaceful and painless death. On the other hand, those who oppose it believe the consequence of any form of suicide will ultimately result in irreparable legal and ethical ramifications. Both sides present coherent arguments, but the delay in us finding a resolution to this discourse only affects the people pleading for their right to peacefully die.
Exit International wants to remove any kind of psychiatric review from the process and allow individuals to control the method themselves, “Our aim is to develop an artificial intelligence screening system to establish the person’s mental capacity. Naturally, there is a lot of scepticism, especially on the part of psychiatrists. But our original conceptual idea is that the person would do an online test and receive a code to access the Sarco,” Nitschke explained.
While this technology could help simplify the whole process of assisted suicide, it also represents the many risks we already associate with the use of AI in our daily life. Tell me, would you trust AI to not be tampered with when it comes to determining whether a loved one’s decision to die is fully their own? That being said, adding an AI system into the so-far unsolvable equation could potentially reduce the uncertainty that comes with human error. Does this mean we’re back to square one?