Voluntary Assisted Dying in Switzerland
and Swiss Option Advisor

Traveling to Switzerland to access medical aid in dying (MAID) is an option for choice in dying that has been getting increased attention in the US. The Swiss call this voluntary assisted dying (VAD). Swiss laws on VAD are much more compassionate in whom they serve than US MAID laws, which are very restrictive. Swiss law only requires that 1) anyone assisting in a chosen death must not have selfish motives, 2) the individual choosing to die must have decision-making capacity, and 3) the individual choosing to die must perform the final action that will bring about death. Importantly, Switzerland allows non-Swiss citizens to come to Switzerland to receive medical support for VAD.

To take advantage of VAD in Switzerland an individual must be over the age of 18.

Advantages

  • People who do not qualify for MAID in the US, often do qualify for VAD in Switzerland.
  • The physical requirements of self-administering the lethal medication or pressing a button are significantly less than what is required to use inert gas for self-deliverance in the US.
  • Some people want to avoid exposing friends or family to the real or imagined legal complications in the US of do-it-yourself methods of self-deliverance.

Disadvantages

  • The costs of VAD in Switzerland plus travel are considerable.
  • Assembling the necessary paperwork can be challenging.
  • The physical demands of traveling abroad can be strenuous.

The following information was compiled in December 2024.

The following Swiss organizations work with non-Swiss citizens seeking VAD:

Dignitas

Pegasos Swiss Association

The Last Resort (not accepting applications, Dec 2024)

  • Founded in 2024 without a physical location
  • Provides non-medical VAD via the Sarco, a device that rapidly produces nitrogen hypoxia
  • http://www.thelastresort.ch
  • Involved in court proceedings challenging the legality of its self-deliverance method, so not accepting applications as of Dec 2024

Those applying for VAD in Switzerland must be over the age of 18 and meet the requirements of the Swiss law; they must have decision-making capacity and the physical ability to perform the last step of the VAD process (drinking the medication or opening an IV line containing the medication). All organizations require the individual’s choice to be their own and stable over time. Those applying for VAD with Dignitas or Pegasos must be a member of the organization.

The Dignitas website states applicants must have “a disease which will lead to death (terminal illness), and/or an unendurable incapacitating disability, and/or unbearable and uncontrollable pain.”

The Pegasos website states, “Pegasos 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.”

The Last Resort requires applicants to be over the age of 50.

For the organizations providing medical VAD (Dignitas, Pegasos), there are at least three costs one should anticipate. Pricing structures are always subject to change, and applicants for VAD should confirm with the organization at the time of application. While there may be extenuating circumstances under which a partial refund of an application or final-VAD fee might be issued, do not plan on it.

Both organizations philosophically believe that financial resources should not be a barrier to accessing VAD, but have considerable operating expenses. Dignitas may be able to offer reduced membership and/or VAD fees for individuals with modest financial resources; any arrangement must be made directly between the member and Dignitas. Pegasos hopes to be able to offer reduced fees in the future for those with financial need. Switzerland’s currency is the Swiss franc (CHF). Over the past five years, on average, one Swiss franc has cost about US $1.09.

  • An initial/annual membership or supporter fee
    For Dignitas, there is a one-time fee to join of CHF 220 and an annual fee CHF 80 after that.
    Pegasos membership is CHF 100 annually.
  • Fee for the VAD process
    This is typically paid in two installments, the first at the time of application and the second prior to scheduling the VAD. The fee includes services provided by the organization and their medical VAD providers, as well as cremation, shipping the cremains to the US, and the death certificate. Occasionally, situations require additional review or additional medical or capacity screenings, and those would be an additional cost. The base fee for VAD with Dignitas is CHF 11,000 and for Pegasos is CHF 10,000.
  • Travel and lodging expenses
    These can vary widely, but plan both for your travel expenses, and the travel expenses of a companion. The latter might not be needed, but circumstances and requirements vary.

The Last Resort, which provides VAD outside the medical system does not charge for the use of the Sarco, but, because it is a new organization which has supported a single exit, there is considerable uncertainty about what and how much associated costs might be. Possible costs to consider are:

  • A capacity assessment in Switzerland
  • Location for the VAD. As far as we know, The Last Resort does not have a physical location, but may provide support in finding a location.
  • Nitrogen used in the Sarco (~CHF 18)
  • Body removal, cremation, shipping the cremains, and a Swiss death certificate. These costs will vary depending on the Swiss Canton in which the individual dies; anticipate a few thousand Swiss francs.
  • Travel and lodging

Swiss VAD organizations use the terminology “green light” to signify that an individual’s application has been provisionally accepted. Provisional acceptance means that the organization has reviewed the application and believes that they will be able to support the individual seeking VAD. All approval is provisional, because the final decision ultimately rests with the organization’s representatives, including a physician, whom the individual will not meet until arriving in Switzerland.

Applicants should expect to supply medical records with their application, though their use varies between the organizations. Medical records are used to satisfy government regulations, evaluate acceptance criteria, and check for contraindications to the medications or method used for VAD.

Because Swiss authorities require specific documentation, it is advisable to begin the application process at least six months in advance, though it may be possible to apply and receive VAD more quickly than that. While you may be able to apply with existing versions of some documents, other documents, including birth, marriage, and divorce certificates, may need to be re-issued within six months of the VAD, and possibly certified by a notary public. If you were born, married, divorced, or widowed in a country where those records are difficult to get or may no longer exist, the application process will be challenging.

Final Exit Network has a volunteer Swiss Option Advisor who can answer questions and provide guidance. This service is provided free of charge, but is information only. To reach our Swiss Option Advisor:

  • Call our toll-free number 866-654-9156, or
  • Use the Exit Guide Service and End-of-Life Options form on our “Contact Us” page.