Science

An autonomous assisted suicide capsule now approved in Switzerland

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Exit International, a non-profit organization that advocates for the legalization of voluntary euthanasia and assisted suicide, has developed a 3D printed suicide “capsule” called Sarco. The beginning ? The patient lies inside this comfortable capsule, then, when ready, presses a button that triggers the nitrogen emission. Death occurs in about 30 seconds, due to hypoxia, without any pain.

Assisted suicide is a sensitive issue, because religions criticize it morally. Switzerland was the first country to legalize physician-assisted suicide; this law was enshrined in the Penal Code in 1942. Some other countries have legalized this practice: Canada, the Netherlands (only when palliative care does not work), Germany, as well as five states of the United States. United States (Orgeon, California, Montana, Vermont and Washington). Assisted suicide, on the other hand, remains unauthorized in France.

In Switzerland, some 1,300 people died by assisted suicide in 2020, using the services of the two largest assisted suicide associations in the country, Exit and Dignitas. Currently, the practice consists of ingesting liquid sodium pentobarbital, a powerful and fast-acting barbiturate that acts on the central nervous system. The patient falls asleep between two and five minutes after taking this substance, before falling into a deep coma, followed shortly after death.

A fully automated lethal process

Assisted suicide and euthanasia remain highly controversial practices today, strictly regulated; A distinction must be made between the two: assisted suicide implies providing the necessary means for the suicide of a person and it is he himself who performs the lethal act; in the case of euthanasia, a third person kills another. A distinction is also made between active euthanasia and passive euthanasia: in the first case, a lethal product is injected into the patient; the second case is to stop the therapeutic relentlessness at his request: the curative treatment is stopped and the patient’s pain is relieved with sedatives until cardiac arrest.

Some countries, including those mentioned above, allow one and / or the other of these acts. The law authorizing active euthanasia, for example, came into force in Spain this summer; it is also legal / tolerated in Belgium, Luxembourg, Colombia, the Netherlands. Austria plans to allow it next year. Obviously, these practices are reserved for people with incurable diseases, who suffer from pain that palliative care strives to alleviate and are equipped with all the mental faculties that allow them to make this decision.

At the moment, assisted suicide requires the intervention of one or more doctors, both to prescribe the lethal substance and to confirm the mental capacity of the patient who wishes to die. The objective of the Sarco capsule is precisely to free yourself from the intervention of these specialists. The psychiatric evaluation will be supported by artificial intelligence. “Of course, there is a lot of skepticism, especially on the part of psychiatrists. But our original idea is for the person to take an online test and receive a code to access Sarco, ”explains Dr. Philip Nitschke, founder of Exit International.

The Sarco has been exhibited at various artistic events in Europe. © Exit International

There are currently two prototypes and the third is being printed in the Netherlands; the latter should be operational in Switzerland in 2022. The manager specifies that some other projects have been delayed due to the pandemic; In particular, it is envisaged that the capsule is equipped with a camera so that the patient can communicate with external persons. It also remains to add a means to obtain the informed consent of the patient, in a completely automated way.

He will end his life in the place he chooses.

The Sarco can be installed anywhere; Thus, you can imagine that the patient chooses the place of his choice to end his life (at home, on the beach or in any other place that he especially likes). The capsule has been designed to make the act as painless as possible: the patient lies down, answers a series of questions, and then presses the last button as soon as they feel ready. Nitrogen quickly fills the cabin, reducing oxygen and carbon dioxide levels; the patient will feel somewhat disoriented, even “slightly euphoric” according to Nitschke, before losing consciousness. “There is no panic, there is no feeling of suffocation,” he adds. The process takes about 30 seconds.

The capsule has just obtained legal regulatory approval in Switzerland and is therefore expected to be launched in the country next year. If the concept may surprise some people, this capsule represents a new alternative for end-of-life patients who want to end their days with ease and dignity.

It should be noted that assisted suicides remain rare, accounting for around 1.5% of the 67,000 deaths recorded on average in Switzerland each year, according to the Exit association. According to the Association for the Right to Die with Dignity, approximately 200 French people cross the border each year to benefit from this planned death.

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