An interview with Dr. Jean-Emmanuel Strasser, former Vice President of EXIT-ADMD, Switzerland
1. Why was EXIT-ADMD founded? What was your role?
To help people be relieved from the physical and pyschological pain caused by polypathology (multiple diseases), or by a deadly disease.
My role was to assist and accompany these people to their chosen death. I started in 1998 as the Vice President and quit in 2014. Today, I am just a regular member of the association and don't assist suicides anymore.
I got involved with EXIT because it suited my philosophy about life, death, and freedom. When I first became interested in joining EXIT as a member, the President at the time asked me if I would be willing to become an active member as a physician and medical director. I accepted. During my time at EXIT, I have helped over 200 people in the process. And I am very glad to have been useful in that sense. I have never regretted it.
2. Can you tell me what happens when someone decides to enroll in the EXIT-ADMD program? What are the steps from enrollment to the day of death?
First, one is required to be a member of the EXIT-ADMD association and pay the annual membership fee (regular fee = 400.00 -CHF; pension insurance fee = 350.00 -CHF). Second, every applicant has to meet the following criteria to obtain assistance to suicide:
a. Submit a medical report that attests the presence of severe polypathology, or of the fatal character of the disease;
b. Submit multiple requests for suicide assistance - one is not enough;
c. Be fully mentally competent (discernment) at the moment of the suicide
3. What did you find to be the greatest reason why people wanted to end their own lives?
The decline in the quality of life due to handicap and constant pain.
4. How does the individual's personality and mindset change during this process?
For most of them, the possibility to die in a decent and dignified way soothes and reassures them.
5. When someone faces their own death what are some what are some of the experiences and thoughts they go through that are unique to the rest of us?
The great majority of them are very decided to take their lives, and are eager to put an end to their pain. Others want to be sure that they will be helped just in case, but have the desire to live and hope for a new treatment.
6. How does religion play into all of this?
The great monotheistic religions are against suicide, thus most of the time are not supportive of their members who decide to commit suicide. Nevertheless, very few men, or women, of the church, mostly protestant pastors, are supportive of the decision by their parishioners.
Did you experience people becoming more, or less, religious when deciding their own fate?
Usually less religious.
7. How does this affect the family members of the individuals?
In the majority of the cases, 95%, it is well accepted by the families. Some people are opposed to the suicide of their relative for inheritance reasons, but, in the end, they can't do anything about it. Families cannot sue EXIT, since assisted suicide is legal in Switzerland.
8. Did you ever experience cases where people had a change of heart and decided not to go through with it?
Never on the final day. It may happen earlier in the process if the person's health improves, which was about 1-2% of all cases.
9. What did the outside world think of EXIT-ADMD, or similar programs? Were they open to the idea? Or resisted the thought of suicide all together?
Some are in favor, others are against it. Even physicians are divided on the matter. It wasn't rare for the physicians who were seeing our members to refuse to write down the medical report about the patient's state of health, which was required for us.
10. Is there a different trend of people seeking assisted suicide today (2016) versus when the program first started in 1982?
No, I haven't noticed any differences.
11. Do you think the government should have a say in whether or not euthanasia, or assisted suicide, should be legal or illegal?
No, I think that government should not intervene. Although, it should be universally respected by all programs, like EXIT, to have a criterion for acceptance. In particular, the criterion concerning the need for the person to be fully, mentally competent.
12. How do you think we should view death in a social context?
We should view it in terms of freedom. Every individual must be free to choose the way he, or she, will die.