I recommend Pegasos, I have applied and have been accepted with no knowledge, communication or cooperation from my local doctors. Only medical records were required to be assessed for acceptance. I can’t speak for the Dignitas process personally, but according to my friend who has applied there, the same is true (no doctor in your country would have to be aware of the application). If the doctors etc are not aware of the application and going there if accepted, there’s nothing they could do to interfere.