Switzerland - Controversial gas capsule - the Sarco pod as the future of euthanasia?
Switzerland is one of the countries that considers the desire to end one's own life as a civil right, a moment of self-determination. Many countries view this much more restrictively, leading to a form of suicide tourism under the slogan "Last trip to Switzerland."
In this context, the Australian Philip Nitschke introduced the project of a Death Capsule in 2019, named "Sarco" – a reference to sarcophagus – which is a futuristic-looking long capsule intended to enable a painless death without the help of other people. The capsule resembles deep sleep capsules from science fiction movies in appearance. The first use is scheduled for July, and the first person has already entered Switzerland.
In Switzerland, one can – as a non-Swiss citizen – avail oneself of the assistance of specific organizations that provide passive euthanasia. Mostly, the drug Pentobarbital is administered to ensure a painless death. The organization is necessary because in Switzerland, suicide is legal, but that does not mean that lethal drugs are freely available. Only a doctor can obtain the prescription-only Pentobarbital. He can then give it to the person in the context of passive euthanasia.
Sarco Kills with Nitrogen
Sarco simplifies the process because no poison or medication is used. Technically, the capsule is a gas chamber. However, it does not use carbon dioxide – as was once used in the USA – to cause death, but nitrogen. Nitrogen is a naturally occurring gas that can be easily purchased and is, in fact, not poisonous or lethal in the actual sense. Death occurs due to oxygen deprivation. This method of dying is considered painless. Death by nitrogen gas is rare. However, there are always cases of carbon monoxide poisoning. Carbon monoxide blocks red blood cells, and it also results in death due to oxygen deprivation, usually caused by improperly set gas ovens. The twist is that the victims do not notice the lack of oxygen, they fall asleep or do not wake up – a clear sign that they are not experiencing agony. It is essential that the respiratory process continues unimpeded. If the respiratory reflex is suppressed, the body panics against death, as it does during drowning.
In the USA, the death by nitrogen gas was tested on the death row inmate Kenneth Eugene Smith. However, Smith twitched for several minutes. Nitschke attributes this to the fact that the chamber was not filled with gas but that Smith was given a mask. Since it was not properly sealed, Smith continued to breathe in some oxygen from the surrounding air.
Sarco is a mini gas chamber
The Sarco Capsule itself is remarkably simple. The person lies down inside, the glass lid must seal airtight. With a lever, the intake of nitrogen gas and the exhaust of the normal air mixture is initiated. Due to the small volume, the exchange takes place very quickly, and death is supposed to occur in half a minute. The capsule itself is barely larger than a trunk or a sideboard and can be used anywhere. Thus, it can also be used in familiar surroundings such as one's own home or in the garden. With the first use, Nitschke is taking a legal risk, according to the "NZZ." He has already obtained a corresponding expert opinion in 2019, but so far, the machine has not been certified as a medical product.
Nitschke's Sarco is adapted to the legal situation in Switzerland. It is not stated that this form of suicide is legal in other countries. Belgium and the Netherlands have similarly liberal regulations, but they require a medical examination of the death wish. Regarding assistance, the question must be answered. In the case of the provision of a prescription-only medication, the help of a doctor is obviously required. However, there are forms of suicide that do not require assistance. For example, the use of a firearm is a common method in countries with a high rate of gun ownership. It is open whether the provision of the equipment already constitutes passive euthanasia from a legal perspective.
Worldwide, suicide is a contentious issue. Religious groups reject it fundamentally as a sin. Others argue that from the right to end one's own life, a pressure not to be a burden to others quickly arises. It is reported from Canada that poor and expensive patients are practically forced into discussions about assisted death.
Situation in Germany
In 2020, the Federal Constitutional Court ruled that the general right to personality also includes the right to self-determined death, including the right to refuse help from others. With this ruling, the previous legal situation was overturned. To this day, however, the parliament has not passed a law that takes account of this judicial decision. There is a legal gray area that is unbearable for those affected because the help they hope for and that the highest court has promised them is de facto blocked and they cannot wait.
A device like the Sarco-Pod will not be allowed in Germany for the foreseeable future. Nor will Nitschke's proposed "barrier-free" access. And the "last journey to Switzerland" turns out to be more complicated in practice than hoped. Assisted dying involves costs, which aid organizations call sums of around 10,000 Euro. There are countries where clinics support the way through Switzerland. For private individuals from Germany, forward planning is necessary, a call in an emergency would probably not lead to the goal.
Serious suicide helpers see no benefit
Cost considerations cannot be imputed to Nitschke. However, the Australian doctor is possessed by his mission to enable people in need a self-determined death. He dreams of further developing a system like Sarco so that it can be manufactured with a 3D printer. He had already developed a suicide bag for the same method. The nitrogen was introduced into a plastic bag from him. He is also the author of the guide "Going to Switzerland: How You Can Plan Your Final Exit".
Serious suicide helpers see no benefit in Nitschke's approach. They criticize the lack of medical supervision and the risk of errors. They also point out that the legal situation in Germany is unclear and that the provision of the means for suicide is punishable. They argue that the focus should be on improving the quality of life and palliative care for the terminally ill.
The Pegasus euthanasia organization has ended its cooperation with Nitschke. They accuse him of excessive intermediary fees and find his PR noise inconsistent with the actions of death assistants. They want to help people, but not beat the drum for Switzerland's death industry. Pegasus President Ruedi Habegger considers the use of the Sarco system limited, even if it works as painlessly as promised by Nitschke. Most patients would prefer to take a lethal dose or receive an injection, he told the "NZZ," even if a doctor is required. The reason is simple. The dying want to have bodily contact with loved ones. "For most of our patients, it's important that they can have bodily contact with loved ones during death. This is not possible with the Sarco."
Source: Swissinfo, NZZ
In light of Switzerland's liberal views on assisted suicide, Kenneth Eugene Smith, an American inmate on death row, attempted to use nitrogen gas as a less painful method of execution in the United States. However, his attempt was unsuccessful due to technical issues with the gas chamber.
Despite the controversy surrounding suicide worldwide, the Sarco capsule, a nitrogen gas-filled capsule designed for a painless death, has found a home in Switzerland, where the desire for self-determination in death is highly valued.
