Dr Erika Preisig says that helping people die in Switzerland gladdens her heart
“The joy of the dying gives me strength to go on,” says Doctor Erika Preisig. The 61-year old originally became a doctor to save lives. However, now she fights for the legalization of assisted suicide abroad and herself helps people die. In Switzerland, where she lives, this has been legal for over 100 years.
This week, Germany became the latest country to legalize assisted suicide. But Switzerland remains the place most associated with the practice. So-called “death tourists” – foreigners who don’t have the option of assisted suicide in their home country – still come to Switzerland from all over the world to die. According to Dignitas, one of the leading Swiss assisted suicide associations, of 256 people whom they helped to commit suicide in 2019, 42 came from the UK. And demand is on the rise.
Preisig is the founder of the foundation “Eternal SPIRIT”, which grants their most desperate patients the chance to end their lives. Preisig was first confronted with the topic of assisted suicide in 2005, when her father tried to kill himself and failed. She then told him that she’d rather have him commit assisted suicide than jump in front of a train and traumatize the train driver and the passengers. So that’s what he did. “As a physician, I felt ashamed of myself for accepting his suicide at the time.” She has, however, been working in this field ever since.
Terminally ill people can get the “green light” — the foundation’s permission to commit assisted suicide – based on their medical condition. Yet two thirds of them don’t actually make use of it; they die of natural causes, but secure in the knowledge that if their suffering became unbearable, an emergency exit would be available. Notably, a majority of them are women. In fact, two thirds of the clients are female. “Many more men commit non-assisted suicide than women do,” says Preisig. “Yet the number of assisted suicides committed by women is a lot higher, since women are more likely to go to the doctor and seek help.”
Like similar organizations, Dignitas insists that it focuses primarily on preventing suicide and suicide attempts. Only when there’s no hope left do they grant their clients the so-called “green light”. That’s why Preisig founded lifecircle, an organization dedicated to promoting a good quality of life rather than a good death. Through lifecircle she can help ensure that even very old and disabled people who are so lonely that they don’t see the purpose in going on living can be cared for by those around them – and suddenly don’t want to die any longer.
Preisig mentions the case of a man who killed himself in an inhumane way after being denied the “green light”. “I looked after this man for three years. For three years I tried to dissuade him from committing suicide. He had depression. I was in legal trouble already, so I couldn’t risk assisting someone with depression without him having been declared as capable of consent by a psychiatrist. So, I told him to go to another organization where there were psychiatrists available.” He went there, but the psychiatrists didn’t realise how he was really feeling and told him that his problems were simply marital ones. Furthermore, they told him that assisted suicide wasn’t an option for him as long as he didn’t solve those problems. “This man jumped straight off the nearest building and died. But first he called his family and his physician – and the police to tell them where they could clean up the mess he was going to make. This kind of things should be prevented. He should have been allowed to die peacefully with his family surrounding him, but that possibility was taken from him by someone who didn’t understand his issues.”
This is not the only traumatic story she has been drawn into. But how does she cope with so much death in her life? “If I were an oncologist and had to administer chemotherapy to people whom I knew had no chance, it would get me down. It would depress me to know that I take quality of life from them, perhaps even extend their suffering.” By contrast, she says, what she does provokes gratitude and joy. “That’s why it’s not wearing work for me. People who are suffering so much that they only wish to push a button to start the lethal infusion and fall asleep forever repay me with an immense amount of gratitude.”
What happens, however, when a patient is physically unable to push that button? No one can do it for them, since euthanasia – as opposed to assisted suicide – is illegal in Switzerland. “When there really is no way for the patient to move or swallow while still being capable of consent, which thankfully doesn’t occur often, we can’t help.” Yet there is a solution for every other situation. “Many of our patients can only move their head or tongue. For cases of this sort we have a special tool which attaches a connecting bar to the infusion. This allows the patient to start the infusion with a head movement.” There also remains the possibility of swallowing the poison.
Even though she finds the relief of her patients uplifting, there is one aspect that gets Erika Preisig down: the grief of relatives who have to let go of a person dear to them. “Sometimes I do cry with them. It happens and it does everyone good. It’s nothing bad, it isn’t a weakness. If I’m sad that we have to let go of someone, I can show it shamelessly. But it can be painful, the grief of those who have to let go. However, the joy of the dying gives me strength to go on.”
Although they have suffered a terrible loss, the relatives are very thankful too, since Eternal SPIRIT helps their loved ones attain happiness. “It’s really quite beautiful. We receive many thank-you letters which are exceptionally important to me. There are many relatives who invite us to their countries. The amount of gratitude is unbelievable, we gain wonderful contacts all over the world. We have already visited families in Quebec and Australia who have lost a family member to our service. We win new friendships.”
Preisig’s work has also affected her feelings towards her own death. Before taking up her activity as a suicide assistant, she worked in the field of palliative medicine and experienced many deaths of patients. “Despite very good palliative medicine I saw people die in ways that made me think ‘I don’t want to die like that. It scares me.’” But ever since her father’s death, her views have changed. “I see the happiness when people can finally go. They don’t have to die; they choose to die. Now it is very important for me to have an open emergency exit.” Still, there remains one set of circumstances that scares her. Her mother died of a cerebral haemorrhage when Preisig was just a young girl. She fears that if this or something similar that leads to severe brain damage was to happen to her, she would lose her capacity of consent and wouldn’t be allowed to commit assisted suicide, even if she wanted to. Her hope is that if she had no capacity of consent, it would mean that her brain is so damaged that she won’t actually suffer. “We can’t know for sure.”
Preisig fights for her convictions. “I think my core message”, she says, “is that each of us should be allowed to die the way they choose to. I want the world to finally comprehend that assisted suicide isn’t a bad thing. Bad for me is when someone throws themselves in front of a train, or if a woman arrives at home to find the hanged body of her husband. Inhumane things like that should not happen. All of us must take responsibility for our lives. So why for heaven’s sake is the way we have to die prescribed? We are perfectly able to take responsibility for our death too! That’s what I want to achieve with my work, that’s what I am fighting for.”
Erika Preisig is not alone in thinking that the freedom to choose when to die should be a universal right. In 2011, 84% of voters in a Zurich referendum agreed that foreigners should still be allowed to commit assisted suicide in Zurich, since most don’t get the chance in their home countries.