Dr Ammouri, a 54-year-old palliative care physician, and Ms Frazier, 49, suffered from medical “frustrations” such as chronic insomnia, dizziness and back pain, Exit International director Philip Nitschke told The Independent. The sisters had planned to travel from their home in Arizona to Switzerland in early 2021, but the trip was delayed due to the Covid pandemic, he said. They first contacted Exit, a non-profit support group for the deaths, in September 2020 to say they were exploring options for suicide. “The explanation was that it was not 100 percent good. They were complaining about what you might call frustration. “Disc collapse, chronic back pain, chronic insomnia, dizziness,” Dr. Nitshke told The Independent. “They both decided they were tired of life and it was time to leave. “What was very clear was that dying together was non-negotiable, it was very important to them.” The sisters also revealed to Dr. Nitshcke that they had gone through a “problematic” period in their lives. “They did not give us many details, but said they had helped each other during a difficult time and saw themselves as each other’s best friend.” They joined the Exit in October 2020, which provided them with DIY manuals on how to take their lives. But Dr Nitschke said the sisters were concerned the procedure might fail and brought them in contact with Pegasos, a Basel-based assisted death agency, which is one of the few clinics that does not need proof of terminal illness. Philip Nitschke, director of Exit International, says the Arizona sisters were “tired of life” (Exit International) They joined Pegasos in March 2021 and originally intended to travel to Switzerland shortly afterwards, but were delayed as Covid-19 cases increased in Europe and the US. Dr Ammouri and Ms Frazier flew to Basel on February 3 without telling their surviving brother and only relative, Cal, who lives in New York, to colleagues or friends. In Pegasus, they underwent a full psychiatric examination and a “thorough check of their data” to ensure that the information they provided matched. “The Pegasus felt comfortable that everything about their history was exactly as they described it.” They died together on February 11. In a statement to The Independent, Pegasos CEO Reudi Habegger said the agency had worked closely with medical professionals and local authorities before determining whether customers were fit to die. “After careful clarifications and within the framework of official rules, we respectfully accompany people with unbearable suffering on their last journey.” Dr Habegger said Pegasos was committed to ensuring that adults “capable of crisis could exercise their right to a self-determined, human death”. Pegasos, based in Basel, Switzerland, offers full medical assistance to the death service for $ 11,000 (Pegasus Association) Dr Ammouri and Ms Frazier’s colleagues sounded the alarm when they did not go to work on 15 February. Colleague David Biglari said he was worried when no one had heard from the brothers for a week and received a strange text message on February 10 with an uncharacteristic spelling mistake. The message read: “Hello! I’m sorry you needed surgery. I hope you are [sic] the pain is controlled. “I’m in Europe right now for a short vacation.” On March 23, a representative of the Basel-Lancaft Public Prosecutor’s Office confirmed to the Independent that the sisters had committed suicide within the Swiss “legal framework”. “They both committed suicide – with the help of a suicide-assisted organization,” the spokesman said. Cal Ammouri told the Independent that he was shocked to learn that his “special” sisters had decided to commit suicide without telling him. Friend David Biglari said he became suspicious after receiving a message from one of the missing sisters with an uncharacteristic spelling mistake (Fox10) Dr Nitschke said he was also surprised the sisters did not inform Cal. “The common reason for this is that people are afraid that there may be some attempt to thwart their plans, so not being very clear about what is happening means that you will not make anyone try to stop it. “They made it clear that they implemented welfare for their brother, but that does not explain why they did not say anything.” The Daily Mail reported that Dr Ammouri placed her $ 1 million Arizona home in a family trust less than two weeks before she traveled to Switzerland, allowing the property to be transferred to immediate relatives without formal legal proceedings. As a hostel specialist who had spent years caring for patients who were seriously ill and dying, Dr. Ammouri would have been “well aware of the limits of palliative care,” Dr. Nitschke said. A longtime volunteer euthanasia activist, Dr. Nitschke said he had seen an increase in the number of people asking for end-of-life choices who were worried that “we are going to slip into some kind of planetary crisis”. The climate crisis and the war in Ukraine have fueled people’s sense of existential terror, he said, adding that Exit had a policy that usually only helps people over the age of 50. Lila Ammouri, a palliative care physician from Arizona, died of assisted suicide in Switzerland (Findatopdoc.com) “The idea was that if you have lived for 50 years and if at that point you decide that your life is something you want to get rid of, then we will talk to you,” he said. “As they grow older, some people come to realize that their health problems will get worse. “They almost try to rationalize or explain to us by trying to cure their suffering so that other people can say it makes sense.” It was “extremely rare” for siblings to choose to die together, Dr Nitschke said. She only knew of another case in Australia in 2017 where mother Margaret Cummins, 78, and daughters Wynette and Heather, aged 53 and 54, decided to end their lives together. In the United States, 10 states and Washington have passed aid laws, and more than a dozen states are considering legislation. The debate is often hotly debated between death rights organizations and opponents, who say the laws are open to exploiting vulnerable citizens who may be suffering from disabilities. Even if Arizona had passed a bill currently under discussion to allow death assistance, the sisters would not qualify to be in the last six months of a deadly illness. Dr Nitschke says Swiss laws giving mentally capable adults over the age of 18 the right to choose to die should be adopted as a legislative model in other jurisdictions. “Under California law, you can suffer horribly, but unless you are going to die in six months, it is not an option. “Most people say ‘it’s my body, it’s my life, I should not be screened by a group of experts.’ If you feel distressed and isolated, or struggling to cope, the Samaritans offer support. you can talk to someone for free by phone, confidentially, at 116 123 (UK and ROI), email [email protected] or visit the Samaritans website for details on your nearest branch. If you live in the USA , and you or someone you know who needs mental health help right now, call the National Suicide Prevention Helpline at 1-800-273-TALK (8255). The Helpline is a free, confidential crisis hotline available to everyone 24 hours a day, seven days a week. If you are in another country, you can go to www.befrienders.org to find a helpline near you.
