On her last day Annemarie Trechsel went for lunch with her ex-husband and son. Afterwards the frail 78-year-old went to her daughter’s apartment in Bern. The Dignitas representative arrived at 1.15pm. Within two hours Trechsel was dead.
“She came back cheerful and calm. She just wanted to get it over with,” daughter Bettina Kläy recalls. “She didn’t want to listen to music, although she loved music. It was as if she was finished with life.”
By allowing Trechsel to come to her home to end her life in June 2004, Kläy was fulfilling her mother’s clearly expressed wish, but she also feared she was opening herself up to the risk of prosecution.
“Assisted suicide is legal in Switzerland as long as the person assisting does not profit from the death. As an heir I was worried that I might face legal problems by having her die in my apartment,” Kläy explained.
In her final years, Trechsel was living in an old people’s home and although the director of the home was supportive of her wish to die, he refused permission for the suicide to take place on the premises.
“That left us with a choice between Dignitas’ apartment in Zurich and my home. When I gave my mother the choice, she much preferred to die in familiar surroundings.”
Suicide protocol
As detailed on the assisted suicide protocol document, the Dignitas representative contacted the police just after confirming Trechsel’s death from drinking a dose of Natrium-Pentobarbital in water. A local policeman arrived within a half an hour and immediately called for back-up and a forensics doctor.
“They investigated everything thoroughly in the bedroom and made us wait outside. They looked for any signs of violence, everything was done above board. Luckily I never heard anything more about it.”
Kläy had a very close relationship with her mother. “She was a lovely person, very communicative. She had poems published. Her independence mattered a lot to her.”
Trechsel suffered a stroke at the age of 72 and was left with serious speech impairment and balance and mobility problems.
“Sometimes when I visited her she would only be able to say one sentence in an hour. That was one of the reasons she wanted to leave life.”
Kläy and her family tried to support her mother living independently as long as possible but, after a bad fall at home, they eventually decided to arrange for the old woman to go into residential care at age 75, with her agreement.
Desire to die
“When she first expressed the wish to die, I tried to dissuade her. I took it as a sign of depression, told her to wait for the spring, she would feel better. But after a while she was hurt that I wasn’t taking her seriously.”
Kläy came round to the idea of following her mother’s wishes. “I saw how unhappy my mother’s sick body and language problem made her and I could really understand why she wanted things this way.”
Trechsel was aware of Dignitas and the work they did but was not well enough to organise everything herself. She asked her daughter to get in touch with the organisation on her behalf.
When the Dignitas representative visited Trechsel she was still able to communicate her wishes and demonstrate that she was of sound mind. She signed the necessary documents. On the day of her death she was also required to sign a final confirmation of her wish to die.
Circle of trust
A small circle of people – Trechsel’s ex-husband, her son, daughter and an old friend – knew about her plans and supported them.
“When we fixed the day about a month in advance, the waiting was the worst part. Knowing that my mother was going to die on day X but still having to go on with my day-to-day life in the meantime was terribly hard.”
“It was nice in the end, a peaceful, dignified death. Of course my heart was broken but it felt OK that my mother got what she wanted.”
“In that way there was no shock. It would have been harder for me if she had suddenly changed her mind because we had travelled down the road so far together.”
The family were unsure at first what to tell other people about the circumstances of Trechsel’s death. “At first we were only going to tell close family members the truth but my brother thought we should stand behind what happened so we told everyone the truth and that was good.”
Kläy was positively surprised at how understanding people were. “We also had people coming to us with similar stories about people in their lives. It [assisted suicide] is more common than you think.”
Swiss law tolerates assisted suicide when patients commit the act themselves and helpers have no vested interest in their death. Assisted suicide has been allowed in the country since the 1940s.
Death is usually induced through a lethal dose of barbiturates that has been prescribed by a doctor. Ingestion of the poison, whether by drinking it or through the use of intravenous drips or stomach tubes, must be carried out by the person wanting to die.
A 2006 decision by the Swiss Federal Court ruled that all people of sound judgment, irrespective of whether they suffer from a mental illness, have the right to decide the manner of their death.
The government examined various options to regulate assisted suicide practices and in June 2011 decided not to seek legal changes but to boost suicide prevention and palliative care.