By ALISON LANGLEY
Published: February 04, 2003

On a Monday morning in mid-January, Reginald Crew, a retired auto worker, flew in from Liverpool to kill himself.

The 74-year-old Englishman, who suffered from motor neurone disease, met a doctor at 10 a.m. In accordance with Switzerland’s liberal euthanasia law, the doctor agreed that Mr. Crew was terminally ill and prescribed a deadly barbiturate, pentobarbital sodium.

By 3 p.m., Mr. Crew, a wheelchair-bound paraplegic in constant pain, sipped, through a straw, some water containing the barbiturate. Four minutes later, he was dead. His wife and his daughter were at his side.

The Crews were among a growing number of people known in Switzerland as suicide tourists — the desperately ill who long to end their suffering, and come here to do so legally.

In 2000, three foreigners committed assisted suicide in Zurich. In 2001, the number of death tourists rose to 38, plus 20 more in Bern. Last year, in Zurich alone, 55 foreigners came to die by their own hand in a strange land in an apartment not their own.

Most of those deaths occurred in Gertrudstrasse, in a working-class section of Zurich, in an apartment rented by Dignitas, one of four groups that have taken advantage of Switzerland’s 1942 law on euthanasia to help the terminally ill die.

While the three other groups focus primarily on the terminally infirm in Switzerland, where scores of terminally ill people are assisted in dying each year, some three-quarters of the 2,500 members of Dignitas are foreigners.

Dignitas was founded by Ludwig Minelli, 70, a portly former journalist who, in midlife, became a lawyer and devoted his attention to Switzerland’s oldest assisted suicide group, Exit. He started Dignitas in 1998, he said in an interview, to help others to die with a dignity they cannot find in their own countries, which in Mr. Minelli’s opinion have ”laws from the Middle Ages” on euthanasia.

Switzerland is not the only country to have legalized euthanasia for those certified by a doctor to be terminally ill. The Netherlands and Belgium have similar laws, but have attracted fewer ”death tourists” because their laws insist that doctor and patient have a close relationship. Germany has firm rules prohibiting euthanasia dating back to the post-Nazi era.

Mr. Minelli said he does not advertise, except through Dignitas’s Web site. Mr. Crew heard about the group from a television program. Most of Dignitas’s members come from Germany, according to Mr. Minelli and the coroner’s office. Fewer come from neighboring Austria and France. Others have traveled from as far as Israel, the United States, Britain and Lebanon, paying Dignitas a $70 registration fee and $30 yearly membership charge. Although some, like Mr. Crew, came with a gaggle of reporters and sold their story to media in their own countries, others cover their own travel and funeral expenses.

It is not the kind of tourism Swiss officials wish to encourage.

”Suicide is not something Switzerland wants to be known for,” said Andreas Brunner, a prosecutor for the canton of Zurich. ”This kind of tourism isn’t the proper thing for Zurich.”

To date, no charges have been filed against a person helping someone commit suicide. Mr. Brunner said he was investigating Dignitas’s assistance of a person who was supposedly depressed but suffered no terminal illness.

The terminally ill would be better served dying at home, he said, adding that groups like Dignitas should campaign to change the laws in other countries.

Congresswoman Dorle Vallender wants to change the law to prohibit death tourism, and has proposed a bill that would regulate euthanasia groups and make the rules more cumbersome so that those wishing to die have more time to think about what they are doing.

”I’m not against assisted suicide,” Ms. Vallender said. ”But with Dignitas, it all happens too fast. They come here in the morning and are dead in the afternoon.”

”We have a duty to make sure they really can’t be helped and are making this decision without pressure,” she said.

Back in 1942, Switzerland’s euthanasia law was intended to help those with only a few weeks left to live die in a dignified way. For decades, there was an unwritten rule by established euthanasia groups to accept only Swiss citizens.

”At the time, it was thought that each person could freely decide their own fate,” Ms. Vallender said. Lawmakers at that time could not foresee any instance where people would travel from another country to die.

More than a half-century later, though, as medical advances have extended life, an increasing number of people throughout the world are questioning the value of that endurance, Mr. Minelli said.

”We can prolong life,” he said. ”But my concern is that many people don’t want to live any longer when their quality of life is gone.”

The law states that a doctor must first diagnose the illness as hopeless or the disability as unreasonable. The person who wishes to commit suicide also must be of sound mind. Finally, the death must be witnessed by three people, one of whom must be a disinterested party, such as a nurse or physician.

Until recently, few took notice of the handful of people who ended their own lives each year.

Now, however, foreigners like Mr. Crew have turned their act into a political statement intended to sway public opinion in their home countries.

The Crew family’s travel expenses were paid for by the ”Tonight With Trevor McDonald” show, broadcast on Britain’s private Independent Television network, which bought exclusive rights to the story for an undisclosed sum.

A week before, an 81-year-old German with Parkinson’s disease, Ernst-Karl Aschmoneit, arrived at the Gertrudstrasse apartment with seven television crews and five newspaper journalists.

Last November, a Parisian woman named Marie Hascoët granted French television permission to film her death. A newspaper reporter accompanied her and the crew.

Mr. Minelli dismisses Mr. Brunner and Ms. Vallender simply as xenophobes. ”If someone is needlessly suffering, a real human need of assistance also exists and I don’t care where they are from,” he said.

Dr. Wulf Rössler, head of the psychiatric clinic at the University of Zurich, said the central question was whether society wanted to help the gravely ill die. Suicide is contagious, he said, citing studies that show that a highly publicized suicide tends to beget copycat cases.

The neighbors in Gertrudstrasse certainly dislike the notoriety that comes with all the television cameras. ”It doesn’t belong in an apartment building,” said Pius Schwendimann, who lives downstairs from Dignitas’s fourth-floor premises. Every time a coffin is carried down, he said, ”it’s creepy.”