Visits to the end-of-life Centres Visits to Pegasos

Updated 7th Nov, 2026

“Most people who get a Yes want to come straight away”

The mission statement of Pegasos is commendably clear. It believes “that it is the human right of every rational adult of sound mind, regardless of state of health, to choose the manner and timing of their death”. However, such clarity inevitably becomes more blurred when it comes into contact with reality. Particularly the current Swiss laws on Assisted Dying.

When I first went to Pegasos in 2022 they were handling around 120 VADs per year and were operating from a small converted apartment on an industrial estate in Liestal.   Now, they have their own purpose-built facilities in the nearby rural village of Roderis.   It contains two separate VAD suites which can be used simultaneously.   They have retained the apartment in Liestal itself.   Their activity has now grown to almost 300 per year.

Their initial slightly idealistic mission statement has been retained so far as possible but, as all the other VAD providers have also found, things are rarely that simple.   The approval of two Swiss doctors is required to confirm the “sound mind” of the patient. Without it, the pharmacists will not provide the medication.   There have been issues with a few patients who have wanted to come alone but have not kept their families properly informed about what they are intending to do.   In 2024 and 2025 there were administrative and communication problems, probably due to the rapid rate of expansion – no such problems have been reported in 2026.

Growth from 120 cases per year to 300 is certainly impressive.   Admittedly,  worldwide demand has grown rapidly during the past four years but, nonetheless, it is Pegasos that has taken the biggest share of that increase.

The reasons are fairly clear.

A cannula in your arm, picture windows and greater awareness

One factor that is not a reason is price.   Although the basic Pegasos fee of 10,000 Swiss francs is 13% lower than that charged by Dignitas, this is not a price-sensitive market.   Anyway, Pegasos is still considerably more expensive that Athanasios.

It is likely that the real reasons are the following :

• A VAD at Pegasos is by infusion through a cannula, not a drink.   This results in a much faster sleep and end of life.

• The Pegasos VAD suite is excellent, with its wide picture windows and broad countryside views

• Awareness of Pegasos has risen rapidly, particularly in the USA.   Many cases have generated media coverage.   This has not always been positive but has had the effect of greatly increasing name recognition.

How fast is the application process ?

Although Pegasos has around 3,000 registered supporters around the world, their recent focus has been upon potential patients who are likely to want a VAD in the very near future.   It is possible to join, submit an application, receive approval and undertake the VAD within an overall period of eight weeks.   The second VAD suite at Roderis is also reserved for “urgent” cases where the timescale can be even faster than that.   As required by Swiss law, two doctors are necessary to certify that the patient passes the necessary “sound mind” test ; Pegasos is now content for both doctors to be based in Switzerland and for the first such consultation to take place on a video call.

Do you need to be “ill” ?

There is no need, at Pegasos, to show any evidence of illness in the normal sense.  Applicants need to be of sound mind and must not have been persuaded to use VAD against their will.   Following a recent case, Pegasos will now want some evidence that the applicant’s close relatives have at least been informed about what is going to happen.   But otherwise, your application is likely to be approved.   Financial anxiety, for example, could be an acceptable reason if also associated with advanced age.

Meeting the criteria for Pegasos seems, therefore, to be much simpler and more relaxed than with any of the others.   Certainly, it is presented in less of a bureaucratic way.   However, they are all working under the same Swiss laws and the same regulations.   Pegasos sticks closely to the necessary rules but believes it is unfair and unnecessary to create new ones.

There must be a possibility, therefore, that the Swiss authorities might question whether or not Pegasos really is abiding by the “unendurable suffering” basis on which Swiss VADs are carried out.   There has been no sign of that yet but it should, perhaps, be borne in mind when a choice is being made.

Is the cannula method safe ?

Inevitably, the suffering caused by the failed execution of Christa Pike has caused people to ask whether they might be running a similar risk if they went to a Swiss VAD centre such as Pegasos.   The answer seems to be “no” but all the staff I have met who handle such procedures say that it is certainly not straightforward.   Great skill and experience are necessary to hit the right vein, to make sure that the needle stays in the vein and that the solution is flowing properly through the infusion apparatus.   Care must be taken with the procurement of the medication too.   Many of these factors were absent in Christa Pike’s case.   No such accidents in Switzerland have been reported.   It is almost inconceivable that they could have gone unreported if they had occurred.

Payment

On this website, we have received a number of enquiries regarding Pegasos’s policy of deposits or “up-front payments”.   People have asked about the circumstances in which those payments should be returned and whether or not there is any financial risk.   The Pegasos policy itself is clear.   The deposit is 5,000 Swiss Francs.   If, for any reason, the applicant fails to get the necessary green light then 3,800 Swiss Francs is returned.   The remaining 1,200 Swiss Francs is retained to cover incurred medical and administrative costs.   If the applicant personally chooses not to proceed, then the 3,800 Swiss Francs is, even in those circumstances, returned.   If you cancel very close to your VAD date, a larger part of your deposit will have been spent – so you should expect Pegasos to return a smaller proportion.

Pegasos does not accept credit card payments but debit cards (i.e. bank cards) are welcome.

Hotels

The small hotel next door to Pegasos, the Landgasthof in Roderis, is owned by the Pegasos Swiss Association – part of the same organisation.   It is a small hotel (seven bedrooms) but is frequently used by Pegasos patients and their families.   I stayed there in 2025.   The rooms are good and the food is satisfactory, though this is a “countryside” hotel with not much to do other than countryside walks.   Most visitors seem to prefer to stay in Liestal or Bubendorf.

Until recently Pegasos was recommending use of the Hotel Engel in Liestal.   Sensibly, they are no longer doing so.   It has become one of these automated hotels where guests are expected to check themselves in, figure out their own room keys and generally do everything in the total absence of helpful human beings.   As an alternative, Pegasos is now suggesting the Bad Bubendorf Hotel in Bubendorf.   It has three restaurants, is across the road from a supermarket and guests are served by real people.   Anyway, a hotel with “bad” in its name must be pretty good.   https://www.badbubendorf.ch/en. 

Video

For a video of a VAD taking place, you could get into YouTube and key in “Lauras’s choice documentary”. This takes you to a longish documentary about an Australian lady who ended her life in 2019 at Pegasos. The VAD itself happens in the final ten minutes. I should mention that the procedure was conducted at the old premises of Pegasos in Liestal. The newer surroundings at Roderis are much better.

Summary

Pegasos is now the leading provider of VAD services for non-Swiss citizens.   It has reached that point only seven years since its launch and could not have achieved such success without the enthusiasm and drive of its founder, Ruedi Habegger.   I have always found Ruedi and his team extremely helpful, friendly, efficient and entertaining.   His idealism shines through.   In fact, I sometimes wonder whether his determination to make Pegasos a very patient-friendly organisation might have caused him occasionally to stray a bit too far away from the clinical setting that most people expect.   Personal informality is certainly welcome, particularly in circumstances that are inevitably stressful, but, as the whole team appreciates, the Pegasos medical professionalism must also remain highly visible too.

Ruedi must be doing something right.   In terms of efficiency, expertise, reliability and speed the Pegasos performance is very good.