Interview with Bernhard Sutter, Managing Director of Exit: The cost of death is 7,000 francs

Why this high difference between intent and implementation?
Some think differently. Advances in palliative medicine are amazing. Of course, some die without us. Exit also has a suicidal preventative effect with its advice and explanations.

However, they have a large number of members. How many?
We have 160,000 members in German-speaking Switzerland and Ticino, and 35,000 members in the separate Exit association in French-speaking Switzerland. More than 200,000 people are registered with euthanasia organizations throughout Switzerland.

For what reason?
80% of Swiss people support the right to self-determination. Contrary to the past, most doctors and politicians no longer have a problem with us or the fact that they want to decide for themselves about the lives and deaths of patients. At best, there is still opposition from religious organizations.

But why membership?
This gives you a complete living will, including advice, at no additional cost. We also make all disclosures in case of end-of-life care. And the accompanying suicide is ultimately there for the relatives as well. Long-term members have priority. We are not an emergency organization.

Can you learn something about the relationship between Tina Turner and Exit?
The outlet cannot comment on specific names. We are subject to discretion. The late singer has publicly announced her debut membership on several occasions.

Of course we accept this. So let’s ask us a simple question: What does suicide cost?
Nothing. We work like an insurance company. Annual membership costs 45 francs, but after three years use is free. A one-time fee of CHF 1,100 is sufficient for a lifetime membership, i.e. less than 25 years’ fees. We also help patients who come to us just to commit suicide, but who, unlike current members, have to pay for it. The cost share is between 1100 and 3700 francs.

How do you find such numbers?
We cover the expenses of the organization, our experts, reports, explanations and visits. In full cost calculation, a suicide with an exit is more than 7,000 francs.

How is Exit financed?
One thing is clear: we don’t want to make money by suffering. We finance ourselves primarily through membership fees. About 30,000 members are lifetime members, meaning they have paid a one-time fee. This requires provisions.

You mentioned organization costs: How big is the exit actually?
We have more than 100 employees in German-speaking Switzerland. About 60 percent of these are “volunteer workers”, 10 percent of whom are modestly paid in a part-time job and are usually over 40 years of age. The modest salary should not create false incentives for this job, the low workload reflects the high psychological stress of assisted suicide. You should know that in our business, mistakes are valid under criminal law.

Is the organization growing?
Yes. We have to create capacities because the population is increasing, especially in the older age segments. We have to face the aging of society and the increasing complexity of cases.

Do you have an example for the latter?
Exit is currently only allowed to assist people with judgment. And you have to get the euthanasia yourself. Exit is no longer allowed to assist in moderate to severe dementia – even if written consent was given at the onset of dementia. However, the number of dementia diagnoses and the need for our services in this regard are constantly increasing. Thanks to a constitutional complaint, Canada was able to create the possibility of a “waiver of final consent” in which the patient could preemptively dispose of the right to euthanasia. This change in the law should also be discussed in Switzerland.

Is Switzerland no longer a pioneer when it comes to euthanasia?
We used to be sure. We were evaluated as a reference country in the relevant congresses. But meanwhile, some countries are more advanced than us in euthanasia. Even Catholic Portugal allows active euthanasia.

Does this mean that “death tourism” has dried up in Switzerland?
Probably not that soon. Euthanasia is also permitted for persons who do not reside here in Switzerland. However, Exit only helps people with Swiss residence or passport.

Do you think the laws in this country will change soon?
Dialogue with politicians and society is necessary. In principle, we are happy that the issue is being handled freely in Bern and the cantons, but we would like to make more progress for the suffering people. This is the main goal of Exit. And not committing suicide with multiple partners as much as possible.