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Interestingly, in an attempted shift away from the medical model, Dignitas was reported in the media in 2008 to be trialing the use of exit bags and helium gas, precisely because this method did not require a doctor. The aesthetic considerations of a exit bags, however, meant that they soon returned to using Nembutal. Doctors remain an essential part of the Dignitas VAD process.
In conclusion, as long as the Swiss VAD groups use Nembutal, they will continue to need doctors. This on-going tension between ‘medical paternalism’ (the role of the medical profession in determining who is deserving of help to die) and a person’s lawful right to self-determination, is the subject of much debate and discussion within the Swiss right to die movement. It is a tension which Exit’s Sarco euthanasia capsule (which uses liquid nitrogen and also requires no medical supervision) is intended to address.