The legalisation of assisted suicide and the extent of doctors' involvement in the practice continue to generate heated debate within the medical, political, and religious communities. Historically, the discussion was strongly influenced by the Dutch model that permitted a doctor actively to hasten the death of a suffering patient.1 By the 1990s, however, an alternative model had emerged—physician assisted suicide. This increases patient control by enabling self administration of drugs and limits the doctors' role to assessment and prescribing while involving non-physicians and non-governmental organisations in the dying process.1 2 3 4 5

Recent attempts to make it legal for UK doctors to help patients die failed.6 Although the legalisation debate is likely to continue in the United Kingdom and elsewhere, a new debate focusing on the use of people other than doctors in assisted death seems to be emerging.4 7 8 Non-governmental organisations occupy a central role in facilitating physician assisted suicide in Switzerland and Oregon (USA) and also help to limit the role of doctors. Despite their importance, little is known about their services, controls, and how they fit into the larger medical system.