Controversial gas capsule – the Sarco-Pod as the future of euthanasia?

Switzerland is one of the countries that see the desire to end one’s own life as a civil liberty, as a moment of self-determination. Many countries take a much more restrictive view of this, with the result that a kind of suicide tourism has developed under the slogan “Last trip to Switzerland”.

In this context, Australian Philip Nitschke presented the project of a death capsule in 2019. “Sarco” – an allusion to sarcophagus – is a futuristic-looking elongated capsule that is intended to enable a painless death without the help of other people. Visually, the capsule is reminiscent of the deep sleep capsules from science fiction films. The first use is scheduled to take place in July. The first person is said to have already entered Switzerland.

In Switzerland, even if you are not Swiss, you can seek help from special organizations that provide passive euthanasia. The poison pentobarbital is usually administered to ensure a death that is as painless as possible. The organization is necessary because suicide is permitted in Switzerland, but that does not mean that lethal poisons are freely available. Only a doctor can obtain the prescription-only pentobarbital. He can then, however, administer the poison as part of passive euthanasia.

Sarco capsule kills with nitrogen

Sarco simplifies the procedure because no poison or medication is used. Strictly speaking, the capsule is a gas chamber. Only here it is not hydrogen cyanide – as was the case in the USA – that causes death, but nitrogen. Nitrogen is a naturally occurring gas, can be acquired normally and is not actually poisonous or fatal. Death occurs due to a lack of oxygen. This type of death is considered painless. Death from nitrogen does not normally occur. However, there are repeated cases of carbon monoxide poisoning. Carbon monoxide blocks the red blood cells, and death also occurs due to a lack of oxygen, usually caused by incorrectly set gas ovens. The tricky thing about this is that the victims do not notice the lack, they fall asleep or do not wake up – a clear sign that they are not suffering any pain. It is important that the breathing process continues unhindered. If the breathing reflex is blocked, the body fights against death in panic, just as it does with strangulation.

In the USA, death by nitrogen was tried out on Kenneth Eugene Smith, a man who was sentenced to death. In this case, however, the dying man twitched for minutes. Nitschke attributes this to the fact that no chamber was flooded with the gas, but Smith was given a mask. Because the mask did not seal properly, Smith still inhaled some oxygen from the surrounding air.

Sarco is a gas chamber in small

The Sarco capsule itself is extremely simple. The person lies down inside and the glass lid must be hermetically sealed. A lever is used to start the flow of nitrogen and the suction of the normal air mixture. Due to the small volume, the exchange takes place very quickly and death is said to occur in half a minute. The capsule itself is barely larger than a chest or sideboard and can be used anywhere. This means it can be used in familiar surroundings such as your own home or garden. Nitschke is taking a legal risk with his first use, writes the “NZZ”. Although he obtained a corresponding report in 2019, the machine has not yet been certified as a medical product.

Nitschke’s Sarco is adapted to the legal situation in Switzerland. This does not mean that this form of suicide would be legal in other countries. Belgium and the Netherlands also have very liberal regulations, but require a medical examination of the wish to die. In addition, the question of assistance must be answered. When providing a prescription drug, the help of a doctor is obvious. But there are forms of suicide that do not require such assistance. For example, when using a firearm, which is a common method in countries with a high rate of gun ownership. It is unclear whether providing the device legally triggers passive euthanasia.

Suicide is controversial worldwide. Religious groups reject it as a sin in principle. Others argue that the right to end one’s life can quickly lead to pressure not to be a burden to others. There are reports from Canada that expensive and poor patients are practically forced to undergo counseling on assisted death.

Situation in Germany

In 2020, the Federal Constitutional Court ruled that the general right to personal freedom also includes the right to self-determined death. This also includes the possibility of taking one’s own life and relying on the help of third parties. This overturned the previous legal regulation. To date – four years later – Parliament has not yet passed a law that takes this case law into account. There is a legal grey area that is difficult for those affected to bear because the help they hope for and that the highest court has promised them is de facto blocked and they cannot wait.

A device such as the Sarco-Pod will not be approved in Germany in the foreseeable future. Nor will the “barrier-free” access advocated by Nitschke. And the “final journey to Switzerland” is also more complicated in practice than hoped. Assisted death entails costs; aid organizations cite sums of around 10,000 euros. There are countries in which clinics support the route via Switzerland. For private individuals from Germany, forward planning is necessary; a last-ditch call would probably not achieve the goal.

Serious euthanasia helpers see no benefit

Nitschke cannot be accused of cost considerations. But the Australian doctor is obsessed with his mission to enable people in distress to have a self-determined death. He dreams of developing a system like Sarco so that it can be produced with a 3D printer. He had already developed a suicide bag for the same procedure. Here, the nitrogen was introduced into a plastic bag. He also wrote the guide “Going to Switzerland: How to plan your final exit”.

The euthanasia organization Pegasus has ended its collaboration with Nitschke. It accuses him of excessive agency fees, and the PR hype does not fit with the approach of the euthanasia providers. They want to help people, but not drum up support for the death of Switzerland. Pegasus President Ruedi Habegger believes the benefits of the Sarco are limited, even if the system is as painless as Nitschke promises. Most patients would prefer to take or have a lethal dose injected, he told the “NZZ”, even if a doctor is required for this. The reason is quite simple. The dying are accompanied. “For most of our patients, it is important that they can have physical contact with loved ones while they are dying. That is not possible with the Sarco.”

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