The paperwork requirements
“The centres need to be absolutely sure whose life they are helping to end and why”
All three of these centres require a great deal of documentation before they will conduct an assisted suicide. In each case, the paperwork requirements are similar, but they are not identical.
All of them work to a similar programme, too. First, you need to become a paid-up member (see this section). Then you need to request, specifically, the preparation of an assisted suicide and explain your personal reasons why. Finally, you need to comply with the very tight regulations as imposed by Swiss law Passing the eligibility test is normally referred to as a “provisional green light”. Compliance with the law then involves a complexity of paperwork which is common to all three centres.
It is interesting to note that most people who join one of the centres do not then go on to request the use of its AVD services. Most members never actually apply for a provisional green light. And, at Dignitas, only 13% of people who do receive a provisional green light then go on to make an appointment for an AVD itself.
These figures are not so puzzling as they might seem. Many members join simply to assist with the organisation’s campaigning work. Many others join all three (as I have done) but will only ever use one. Quite often, also, what people really want is the re-assurance than an AVD is ready and available should they wish to use it – which, in fact, they never do.
The reasons for your request
Of the three centres, it appears to be Dignitas which goes to the most trouble at the eligibility stage. Its wording is precise :
“ the member must submit a formal request for an accompanied suicide to DIGNITAS. Based on our experience, one has to consider approx. 3 months for the preparation of an accompanied suicide. This period depends mostly on how fast the necessary documents are provided in the requested quality. This request must comprise :
1. A personal, signed and dated letter to DIGNITAS, preferably typed, in which the member asks for an accompanied suicide with the help of DIGNITAS. The letter must state the reason(s) for making the request and must describe the member’s present physical condition and how it affects him/her.
2. A biographical sketch describing the member’s childhood, school life, family situation and the most important events in life. Furthermore it should inform about who is supporting the wish for a self-determined end of life and who would probably travel with the member to Switzerland. This biographical sketch will help the doctors assessing the request
3. One or more up-to-date medical reports together with two or three older ones. These reports must provide substantial information on the case history, diagnosis, and – if possible- actual and suggested treatment/measures as well as prognosis. The most recent report must not be more than three or four months old, and all reports must be clearly legible
It is important to ask doctors and clinics to provide copies of medical records at an early stage. This will help avoid unnecessary complications and delays. The reports must be in English, French, Italian or German; for other languages official translations must be obtained and provided.”
Until the UK introduced the General Data Protection Regulation (GDPR) in 2018, there were a few cases where doctors would refuse to let a patient have copies of their own medical records. Frequently that was because the doctors suspected that a trip to Switzerland might be on the cards and did not want to get involved. Under GDPR, every patient has a legal right to see his or her own records.
If a doctor now asks you why you want the records, there is no need to be specific. Some patients in these circumstances say they are needed for an insurance policy. I suppose this is still understandable but it is always wise to err on the side of honesty if you can*
*Incidentally, if you really are thinking of insuring your life before choosing suicide, don’t. It can be tantamount to fraud. Most life policies do not cover suicide and if you ask for one that does you will immediately find yourself on a blacklist shared between all the life companies.
If you are contemplating a visit to Dignitas because you have cancer or any comparable illness, you will certainly already have had several visits to your specialist Consultant. It is now standard practice for the Consultant to write to your GP to let him or her know what was discussed. These letters are sent by surface mail and the patient is always sent a copy. This is certainly my experience and I think the system works well. Essentially, the most recent of these letters, together with one or two older ones (preferably from the time of the first diagnosis) is all that Dignitas should require but they may well ask for further details too.
At this point, there is a clear difference between the requirements of Dignitas and those of the other two centres.
Dignitas really do need evidence that there is some medical diagnosis. Getting a provisional green light from Dignitas is certainly no pushover and seems to be harder than with Lifecircle or Pegasos.
Lifecircle need the personal letter and the biographical sketch in the same way as Dignitas. In respect of the medical reports, however, Lifecircle simply need:
- One or more up-to-date medical reports (no older than 3 to 6 months)
- One older medical report with all diagnoses
- The reports should include all diagnoses, present state of health, prognosis, treatment and current medication.
The guidance from Dignitas goes into very great detail about what will be done with the medical information, who will see it and what else they might want. Lifecircle simply say that your request will be transferred to a Swiss doctor and if they agree “that your condition justifies an assisted death and your documents are in order” they will give you a provisional green light. In order words, Lifecircle allow themselves a much greater degree of discretion than is likely under the more highly-specified Dignitas procedure.
Pegasos operate in a way that is strikingly different.
They expect that an application for an AVD will be made online. Their online questionnaire for the purpose seems, on the face of things to be remarkably simple. Once you have become a supporter, you can view it yourself and see what it involves. Their crucial and all-encompassing phraseology is:
“While a person applying for an AVD at Pegasos does not necessarily need to be seriously ill, if the person has had or does have an illness of any kind, Pegasos will require their past and/or current medical history”
There then follows a little box for completion in no more than 300 words.
Does the greater detail required by Dignitas imply greater thoroughness ?
Dignitas has been going longer, handles a greater annual workload and has lengthy experience of dealing with the Swiss authorities. Logically, therefore, people might feel a greater degree of confidence when dealing with them. However, people will also be understandably concerned with the particular requirements of their own case. Would Lifecircle or Pegasos be easier to deal with ? Would they be more understanding of a patient’s own circumstances ?
This website cannot offer advice on such issues and we refrain so far as possible from expressing opinions upon them.
Documentation for the “provisional green light”
The documentation required to get to the “provisional green light” stage varies from one centre to another. After that stage, the documentation is dictated by the Swiss Civil register Office’s regulations. It is therefore common to all three centres.
The originals of all the following documents must be with you when you go to Switzerland. Your chosen end-of-life centre will want to see photocopies of them beforehand.
With the exception of your passport, all the following documents must be no more than six months old.
The documents are :
- Your passport.
- Proof of residence – usually a Council Tax bill, an energy bill, a bank statement or a tax demand. At least two of these will be required – possibly three or four to be sure. These should be as recent as possible and, apparently, no more than four months old. Interestingly, Dignitas also says that the Registry Office they deal with in Zurich requires a full Affidavit of Domicile, for which you will need a Commissioner for Oaths or Public Notary. Most UK law firms have such people.
- Your birth certificate. This will need to be in its long form, showing your parents’ names. The certificate must have been re-issued within the last six months.
All re-issued certificates can be obtained online from the General Register Office in the UK (GRO). They will cost £14.00 each – or £38.00 if you want them the next day. The website is firstname.lastname@example.org . Just as a trial, I applied for a copy of my own birth certificate, online, on the 18thNovember 2021. It arrived by post 22 days later on the 10thDecember, properly certified and dated the 7th December 2021. An excellent service, I thought.
If you are married you will also need to provide :
- Your marriage certificate. Once again, this must have been re-issued within the last six months.
- Your spouse’s birth certificate (long form again), also re-issued within the last six months.
If you are not married and have never been married you will need to provide :
- a Statutory Declaration saying “I solemnly declare that I am single and have never been married”. This will need to be prepared and sworn before a Commissioner for Oaths (any local legal firm will have one) and the whole thing should cost you no more than £100.00. For Dignitas, this status should be covered also by the Affidavit of Domicile, meaning that no separate Declaration will be necessary
If you have been widowed :
- Your former spouse’s birth certificate
- Your marriage certificate
- Your former spouse’s death certificate
If you are divorced :
- Your former spouse’s birth certificate
- Your marriage certificate
- Your divorce certificate
In my own case (i.e. born, married, widowed and married again) this all means that I need to provide my passport, the documents to prove where I live and six separate certificates – all issued within the past six months. This sounds like an enormous burden but actually it is not too bad. If my requirement is not particularly urgent then the cost will be £84.00. If it is urgent and I need everything the next day, then the cost will be £228.00. The time taken to order the whole lot should be less than two hours. The GRO website even includes a “shopping trolley” facility for those who like to buy their certificates in bulk.
Copies from the GRO are automatically “certified” and do not need to be confirmed by a Solicitor or Commissioner for Oaths.Read Next Section >