EXIT: le droit de mourir
Directed by Fermand Melgar.
75 minutes. Subtitles in English and German. 

In the US, UK and Australia, debates on the right to die are always framed in terms of personal autonomy. Choosing death is said to be the ultimate expression of personal freedom. Characteristically, English-speaking euthanasia campaigners focus on pragmatic issues like the time, place and methods of releasing people from physical pain or psychological anguish. The providers of this release are nearly invisible -- shadowy extensions of the patient’s autonomy. 

But there is another side to the right-to-die movement which apparently flourishes in Switzerland, a mystical side with a proselytising spirituality. And if euthanasia were ever legalised in other countries, this is what it might become. A prize-winning 2005 Swiss documentary, Exit: Le Droit de Mourir (Exit: the right to die), reveals the extraordinary philosophy of people who are committed to helping other people take their lives. It has just become available on YouTube and is essential viewing for anyone interested in end-of-life issues. It is absolutely mesmerising. 

Since 1937, assisted suicide -- but not euthanasia - has been legal in Switzerland, so long as no one benefits from providing assistance. As a consequence, private associations dedicated to helping people to die have sprung up. The oldest of these is EXIT, mainly for Swiss German-speakers. Two smaller splinter groups exist, EXIT International, and Dignitas, which promote their facilities for committing suicide in other countries. A fourth group, EXIT ADMD, offers its services mainly to francophone Swiss residents. This is the group which features in Exit: Le Droit de Mourir.

As a documentary, this is an extraordinary piece of craftsmanship. The director, Fernand Melgar, spent two years filming the work of EXIT ADMD. He shows an annual general meeting, secretaries answering phone queries, a conference of EXIT societies in Japan, a board meeting and discussions with clients. Most astonishing of all, he films the last moments of a woman who chose to die on January 22. The photography and editing are breath-taking. One impressive detail: from across the street he films undertakers manhandling a gurney with the woman's body into their van. Cars pass in the drizzle. Suddenly there is a movement in a window of the block of flats, the reflection of a train behind the camera whizzing into the distance. It is an emblem of Micheline’s soul beginning her trip into the unknown...

But the focus of the documentary is on the accompagnateurs, the escorts. They ensure that the client is making a free choice to commit suicide. They patiently reassure them as they slowly make up their minds. They provide the lethal barbiturates and witness the deaths. It is depicted as heart-rending, exhausting work. 

What strikes an English-speaking viewer as odd is the complete absence of controversy. Ethical discussions centre merely on justifying EXIT ADMD’s reluctance to get involved in some cases. The escorts are over-stretched and weary; there are so many people who want to die and they cannot possibly help them all. 

But the escorts press on. Their work is, as their president, Dr Jérôme Sobel, reminds them, not a task, but a “vocation”. (He was recently re-elected president of EIndeed, their involvement is clearly a deep religious commitment. In an extraordinary sequence, Melgar films EXIT ADMD’s board meeting.  In a soft golden glow, twelve escorts sit around a U-shaped table on both sides of Dr Sobel in a clear evocation of the Last Supper. “You are no longer volunteers, but priests,” Dr Sobel tells them. 

The religious dimension is heightened in the quasi-liturgical language with which the saintly figure of Dr Sobel farewells Micheline. Over and over again he poses the question: do you do this freely? -- to which she murmurs again and again Oui, Oui, Oui... “May the light guide you and lead you to peace,” he tells her. “Bon voyage, Micheline.” And she falls asleep. 

Exit: le droit de mourir is not just evidence that Switzerland has entered the post-Christian era. It also shows how a post-Christian society will end up approaching death. Death, as Sobel and his accompagnateurs have recognised, is too much a part of life to be approached with Anglo-Saxon pragmatism. Death demands spirituality. By Christian standards, EXIT’s spirituality seems very thin indeed, but it offers what it can. 

Furthermore, spirituality grows within a community with its own moral codes and mission. Like any community, euthanasia activists are convinced of the justice of their cause and want to spread their vision. They proselytise. This seems to account for the growing proselytism of Switzerland’s assisted suicide associations. They have gradually moved from offering information about poison and plastic bags to offering active assistance. 

A overlooked dimension of the right-to-die debate is that suicide is no ordinary right, like the right to good health care or the right to a passport. For those who believe in it, helping people to die is a deep personal commitment. And this stunning Swiss documentary suggests that if euthanasia were legalised, true believers would aggressively proselytise and promote it with all the fervour of a religion. It is not something to look forward to. 

Michael Cook is editor of MercatorNet. An earlier version of this review was published in 2005 when the film was first released.