A belief in assisted suicide is by no means a fringe view in western Europe. There is broad agreement, associated with notions of modernity and evolved thinking, that suicide is an appropriate action to take in certain cases and should be allowed by law. Nowhere is this more true than in Switzerland. Together, the country’s two Exit organizations lay claim to some 70,000 members, approximating the size of a national political party, and opinion polls routinely indicate that about 80 percent of the population supports the practice. It may seem strange, then, that Ludwig Minelli, operating as he does within such a permissive environment, is almost universally reviled. Everywhere I went in Switzerland, mention of his name evoked smirks of disgust followed by insults. The question was why.
I visited Minelli at his home, a few blocks from Dignitas’s administrative office in Forch, a quiet Zurich suburb about 10 miles west of the new death house. We sat on a plaid couch drinking tea and eating sugar cookies. Built-in bookshelves holding the great works of Western humanism lined the walls. More’s Utopia was displayed prominently, its front cover turned outward among the spines of other books. I asked Minelli why, despite strong public support for assisted suicide, he is so widely despised. He said, “It’s well known in sociology: not in my backyard.” There’s something to this. The two Exit organizations, by catering only to Swiss residents, are able to make house calls and help people die in the privacy of their homes. But Dignitas, with its international clientele, requires a facility in which to conduct its business. The continuous parade of people who arrive living and leave dead lends Minelli’s operation a faintly industrial aspect.
For several years, Dignitas used an apartment in a small residential building in Zurich for its accompaniments. The group was forced out by a local politician in September 2007, and since then has behaved like a guerrilla organization, constantly on the move. Dignitas briefly relocated its death house to another apartment block, but lost its lease after neighbors objected to the sight of paramedics carrying corpses out to the street. So Minelli offered up his own living room. “Here there was a bed,” he told me, pointing to the coffee table. “We had two accompaniments right here.” Once again, though, Dignitas had to relocate when the city council forbade the group from playing host to more suicides.
Minelli provoked still more outrage when he responded by ordering his staff to begin administering sodium pentobarbital in hotels. Perhaps 20 people killed themselves in their rooms, drawing ineffectual protests from the local hoteliers association. Swiss sensibilities were further offended when it became known that Dignitas had arranged for two Germans to commit suicide in their cars by the side of the road. Minelli chafed at the widespread criticism the deaths inspired. When I asked about it one morning, he insisted on driving me to the spot where the two Germans had died, to prove it was not near a busy highway, as newspapers had reported. Pulling up to an abandoned restaurant in the countryside near his house, where several people were out jogging and walking dogs, he gestured to the surrounding woods and meadows and said, “No highways.” A few years earlier, when the restaurant folded, the property title had passed to a Zurich bank. After learning of the suicides, the bank’s lawyers had warned Minelli to stay away. He flashed a smile as we drove on, noting that they had yet to erect any fences to keep him out.
Minelli’s purchase of the Blue Oasis has at least temporarily ended his need for hotel rooms and isolated parking lots, but the public anger he arouses has fueled numerous other tales of scandal. People say he takes wallets from the dead and removes their watches, jewelry, cell phones, and even cancer wigs for resale at local thrift shops. Though Minelli shows no sign of ostentation, many Swiss believe, without evidence, that he has amassed a fortune in fees from those he has helped to die. Even more-outlandish rumors suggest he keeps a private stash of sodium pentobarbital for use in a pinch, and that Dignitas escorts administer less than the recommended dose in order to sell the remainder on the black market. (Sodium pentobarbital has a narcotic effect in smaller doses.) Such accounts, many of which have found their way into European newspapers, are almost certainly the product of a personal vendetta against Minelli by a disgruntled former Dignitas employee, whom even Swiss prosecutors investigating the organization’s activities have disavowed as a fantasist.
But at least one rumor appears to be true. People committing suicide at Dignitas typically request to be cremated. Minelli told me he stores the urns until he has enough to fill his car. Then he drives, usually at night, to a quiet spot nestled among the multimillion-dollar houses on Lake Zurich, and tosses the remains into the water, urns and all. He insists these burials are harmless, but last year he received a threatening letter from Zurich’s water authority after wealthy homeowners complained of ashes and what they believed to be human bone fragments washing up on shore.
Is a story like this, widely reported in the Swiss press, enough to account for Minelli’s toxic reputation? Possibly so. But there is also something intrinsically discomfiting about where this man’s idealism has taken him. He views his work with Dignitas as a struggle for a basic human right. But even if you grant the justice of his cause, it’s hard not to conclude that his pursuit of it—expressed by helping more and more people to kill themselves—has led him deep into an ethical wilderness.
Minelli is outspoken in his desire to do away with anything that might restrict the practice of assisted suicide. Last April, in an interview with the BBC, he went so far as to call it “a marvelous possibility given to a human being” to escape suffering. In Switzerland, such situations are not limited to terminal illness. The country’s assisted-suicide groups accept patients who have incurable diseases but might, with proper care, live on for many years. They will also occasionally assist in the deaths of people suffering from debilitating mental illnesses like schizophrenia and bipolar disorder. This is perfectly legal, provided a psychiatrist will attest that the patient’s wish to die is not merely a symptom of his disease. But only Minelli believes that sodium pentobarbital should be made available without limitation to people with no illness at all.
Take the case of an elderly Canadian woman named Betty Coumbias. Though her husband was suffering from heart disease, she was in fine health when they traveled to Switzerland in 2007. A documentary film chronicling their journey shows the couple sitting in Minelli’s living room, asking him to arrange for their double suicide. “From the day we got married, [my husband] was all my life,” Coumbias explains. “I love my two daughters, but I love him more, and I don’t think I can face life without him, and since we read about Dignitas, we felt, what would be better than to die together, you know, to die in each other’s arms?” The couple ultimately returned to their home in Vancouver after a Swiss doctor refused to prescribe the required amount of sodium pentobarbital on grounds that the couple was too healthy. But Minelli is now using their case to pressure Zurich’s medical authorities into granting doctors permission to prescribe lethal drugs for virtually anyone who might want them.
The need for sodium pentobarbital has been a recurring problem for Dignitas and a vulnerability that has periodically threatened its operation. Swiss physicians act as gatekeepers on the drug’s distribution, and nearly all of them refuse to work with Minelli. Today, there are only four doctors in the entire country who will do so; one of them told me that for a short time last year, there were none.
Minelli’s reputation has much to do with this, but it is also a reflection of broad concern over the ethics of suicide tourism. Switzerland’s domestic-suicide groups often obtain lethal prescriptions from doctors who have known their patients for years and are intimately familiar with the details of their medical histories. Dignitas, because its clients are largely foreign, is unable to do so, and so its physicians are compelled to make hurried decisions regarding life and death. For most of its history, the group has facilitated suicides on the basis of a single appointment. Patients would go directly from the airport to the doctor’s office to the death house, all in the same day. The practice drew harsh criticism in the international press, so, in December 2007, Zurich’s chief physician upped the requirement to two doctor’s appointments. In regulatory terms, the difference was almost absurdly trivial, but it proved sufficient to invite Minelli’s fury. He viewed it as a personal attack, and his response was as swift as it was extreme: a series of four “demonstration” deaths using helium gas. The suicides gave Minelli the opportunity to experiment with new methods and served as a not-so-subtle reminder that, if necessary, he could continue on even without doctors and their sodium pentobarbital.
Minelli himself is never present at the death house, preferring to leave such hands-on work to his staff. He insists this is not because he is squeamish. “I know that I would not be uncomfortable with seeing people die,” he told me. Rather, it’s that “good management does not mix supervision with action on a ‘lower level’ of an organization.” Minelli denied that the arrangement is meant to provide legal cover, but acknowledged, “In case something happens on the lower level which is not in accordance with the law, it would not be easy for the authorities to open an action against [me].” He was absent even for the two accompaniments held in his own living room. But during the helium demonstrations, Minelli broke with convention and witnessed a suicide for the first time, though, he was careful to point out, he left before the patient was officially pronounced dead. He was pleased with the results. “I think it is the best method,” he told me. “But it is not nice to see … Muscles are agitated. Eyes open wide and close. Arms and legs twitch without coordination. And if you are not well informed, you might mistake this for a terrible struggle against death, which it is not. It’s just the same as when you cut the head off a chicken.”
Death by poison gas carries certain historical associations in this part of the world, and the public responded with predictable disgust. In Zurich, I asked a Swiss physician who has done extensive research on assisted suicide what he thought of Minelli’s demonstrations. “The helium cases are the worst thing he has done,” he said. “It’s completely weird, because gas, of course, is associated with the Nazi death camps. Minelli knew that, but didn’t care.”