This is the pdf text Dignitas sent me in July 2018. It is their process for people with mental illnesses.
Personally, I have had trouble locating a psychiatrist (I focused on forensic) in the US that would support such a case (dying with Dignitas). I made about 7 inquiries. They want to help you instead. One said he would do this but was too busy. He quoted me more than $6000 for the assessments. And it was problematic to me that I would need to seek these assessments at thousands of $ in expense, when I had no guarantee Dignitas would accept my case.
I hope this helps!
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Assisted voluntary death proceedings for people with mental illnesses
Some time ago the Swiss Federal Supreme Court has acknowledged that basical- ly every mentally competent person has the right to determine the moment and the manner of his or her own end of life; a court ruling which was confirmed by the European Court on Human Rights. This signifies that mentally ill may sub- mit a formal request for the preparation of an accompanied suicide to DIGNITAS – provided that they are found competent to make a rational choice in his or her own best interest (decisional capacity) and submit an in-depth medical ap- praisal established by a doctor of psychiatry, in which this and other ques- tions are thoroughly assessed, concluding a severe, long term, therapy re- sistant psychiatric illness and confirming decisional capacity in relation to the wish to end life.
Thoroughly assessing the capacity of discernment in regard of a rational and well pondered consideration of the death wish is a very long process. Beside the evaluation of the wish to die, it should include all options for the future. Experi- ence shows the following steps:
in-depth assessment new therapy medical
appraisal
Assessment
Starting point is your current situation. The issue is not that you would wish to die, your goal is not death – but you do not wish to continue with the situation as it is, things need to change, you wish to improve your outlook. This is why you ask for and require an assessment of your current situation, resulting in an in- depth psychiatric appraisal, a special, detailed medical report by a psychiatrist. Such assessment should result in clear findings on the one or more diagnosis and give an overview of all the therapies tried so far. Furthermore, the assessment should investigate whether there are further possible therapies or whether your illness is resistant to therapies. Such assessment may not be possible with the doctor currently treating you. Therefore, it is advisable to look for an independ- ent, open-minded psychiatrist with a forensic/analytic approach. Such independ- ent psychiatrist is more likely to assess your case without prejudice.
New therapy
During this process, new therapies may be suggested. You should try them. If the therapies do not show the desired effect, you can still move on to your re- quest for an accompanied suicide.
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In-depth medical report
If you do not consider any other possibility but accompanied suicide, you should not interrupt any therapy. Instead request an in-depth medical appraisal from a psychiatrist. Such an appraisal should give information as to your mental com- petence and your capacity of judgment in regard of your wish to end your life. In particular it is necessary to distinguish between a death wish caused by a curable psychic disorder and a desire to undergo suicide based on a self-determined, thoroughly considered, deliberate, stable and lasting decision (rationally consid- ered suicide). Requesting and establishing such in-depth report is neither illegal nor unethical. In order to avoid opposition or rejection when requesting such in- depth medical appraisal, it is advisable to first check out carefully the attitude of the psychiatrist.
After having done all these necessary steps, you may submit your formal request for an accompanied suicide. Such request should include:
- a personal, signed letter (preferably typed) in which you request DIGNITAS to prepare an accompanied suicide for you. You should state your reasons for doing so and describe your current health situation and how you experience it.
- a detailed, separate 'life report' (biographical sketch), which contains in- formation about your childhood incl. hearsay about the first five years of life, young adulthood (up to the age of 25) also mentioning your integration with society. Furthermore, the onset of your illness and your perception, your feel- ing. Additionally, it should describe your social and familial situation today. This "life report" may help Dignitas and its cooperating doctors to under- stand your personality and family circumstances and it helps with assessing your request.
- one recent and two to three older medical certificates from your psychia- trist(s) and/or clinic stays or discharge papers, which contain substantial in- formation, such as length of stay, diagnosis established, treatments tried (not just medication), situation at the time of discharge, etc. At least one of the medical certificates should not be older than three months.
- a recent in-depth medical appraisal, established by a doctor of psychiatry. The assessment should show that you are capable of discernment and judge- ment in regard of your death wish. Furthermore it shall attest that you can draw a balance of your past and that you are able to take existential decisions about your future. It should confirm that your wish to die is not a symptom of your mental illness but a well pondered decision.
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Please be aware that only complete and well documented requests can be worked on by DIGNITAS and possibly submitted to a Swiss psychiatrist for fur- ther evaluation.
What can I do if I do not receive my medical reports?
For this, you can check the internet to find out more about the patient's rights in your country.
How can I find a psychiatrist for the in-depth medical report?
- - As mentioned earlier in this paper, the in-depth psychiatric assessment is best done by an independent psychiatrist with a forensic/analytic approach. Such independent psychiatrist is more likely to assess your case without prejudice.
- - Research the internet and/or your local telephone directory by using key words such as: medical expert, psychiatric expert, forensic psychiatrist or psychiatric assessment.
- - Visit your local public library or a bookstore. Look for professional literature on the subject of forensic psychiatry and medical-psychiatric assessments and copy the authors list. Or google published studies and look for the authors and contributors.
How can I confront the opposition and/or rejections when requesting the in- depth psychiatric report?
- - As much as possible, never appear desperate.
- - Do not give your wish to end your life as a primary reason to request an in-
depth report. Remember: the issue is not that you would wish to die, your goal is not death – but you do not wish to continue with the situation as it is, things need to change, you wish to improve your outlook.
- - Choose a forensic, and/or a scientifically oriented, analytical thinking psychi- atrist.
- - Before anything, carefully check out the attitude, the views of the psychiatrist you would wish to do the report.
Yours sincerely,
DIGNITAS
To live with dignity - To die with dignity