Background In Switzerland, right-to-die organisations assist their members with suicide by lethal drugs, usually barbiturates. One organisation, Dignitas, has experimented with oxygen deprivation as an alternative to sodium pentobarbital. Objective To analyse the process of assisted suicide by oxygen deprivation with helium and a common face mask and reservoir bag. Method This study examined four cases of assisted suicide by oxygen deprivation using helium delivered via a face mask. Videos of the deaths were provided by the Zurich police. Dignitas provided (...) protocol and consent information. Results One man and three women were assisted to death by oxygen deprivation. There was wide variation in the time to unconsciousness and the time to death, probably due to the poor mask fit. Swiss law prevented attendants from effectively managing the face mask apparatus. Purposeless movements of the extremities were disconcerting for Dignitas attendants, who are accustomed to assisting suicide with barbiturates. None of the dying individuals attempted self-rescue. Conclusions The dying process of oxygen deprivation with helium is potentially quick and appears painless. It also bypasses the prescribing role of physicians, effectively demedicalising assisted suicide. Oxygen deprivation with a face mask is not acceptable because leaks are difficult to control and it may not eliminate rebreathing. These factors will extend time to unconsciousness and time to death. A hood method could reduce the problem of mask fit. With a hood, a flow rate of helium sufficient to provide continuous washout of expired gases would remedy problems observed with the mask. (shrink)

In a former paper I endeavoured to show that the myth in Plutarch's de facie is a conscious imitation on a small scale of the Timaeus of Plato, and that therefore we might conclude that Plutarch, who regarded the Timaeus as serious philosophy, intended the main point of his own myth, the derivation of mind, soul and body from the sun, moon and earth respectively, to be taken literally. This conclusion will be equally true of the myth of the de (...) genio, if it can be shown, first, that the two myths present what is essentially the same psychological theory, and, secondly, that there is no internal inconsistency in the myth of the de genio, such as to justify von Arnim in concluding that it consists merely of two incompatible doctrines from different sources arbitrarily placed by Plutarch in juxtaposition. The present paper is an attempt to establish these two points. (shrink)