A growing number of elderly Australians are fearful enough of the process of dying that they are willing to contemplate suicide, reports Tim Cannon.
An air of morbid frivolity hangs about the travelling road show that is Dr Philip Nitschke. A smirking suicide proselyte, there can be no doubt that Nitschke’s mesmerising soft talk of choice, freedom and compassion has won him a multitude of adoring fans. For a modest fee, this gentle fellow will teach you his finely honed method of achieving a “peaceful end”.
After a whirlwind tour of the UK, and a brief stopover in Singapore, the famous Dr Nitschke is back on home soil, for a succession of one-night-stands throughout Queensland. His return coincides with the introduction of a bill to legalise assisted suicide in the Tasmanian parliament. Moves are afoot in Western Australia to introduce similar legislation, following the tabling by Greens MP Robert Chapple of a petition in support of assisted suicide. Meanwhile a voluntary euthanasia bill lies dormant in the South Australian parliament, introduced last year by Greens MP Mark Parnell.
The timing of Dr Nitschke’s return highlights a groundswell of support for assisted suicide in Australia. In Mackay he drew a crowd of over 150. There were more than 100 in Cairns. For Nitschke, these outings were a great success, far exceeding his expectations.
In fact these days, with his publicity machine firing on all cylinders, Nitschke rarely fails to draw a solid crowd of generally good-natured citizens dead-set on learning how to kill themselves. For anyone touched by the tragedy of suicide, it is enough to make your stomach churn.
When it comes to suicide advocacy, Nitschke is about as extreme as they come. Back in 2001, in an interview with notable American journal, National Review, he suggested that a “… ‘peaceful pill’ should be available in the supermarket so that those old enough to understand death could obtain death peacefully at the time of their choosing…”
These days Dr Death is more coy. Speaking to the Mackay Daily Mercury (May 29, 2009), he insisted that his message is not for the mentally unstable or the young. His closed “members only” seminars – wherein participants receive detailed suicide instructions – are now restricted to persons aged 50 and above, although Nitschke admits that this age limit is arbitrary. His only real criterion is that suicide-information-seekers be “rational”.
In the same interview with the Daily Mercury, the good doctor baulks at the “extremist” label, suggesting “…[t]here’s nothing extreme about wanting options at the end-of-life”. But this is just another trick – a sleight of tongue – from this master of illusion. For human beings, death is as extreme as it gets. It is the definitive point of no return. Advocating suicide can never be anything but extreme.
It is unclear whether the sheer immensity of what is at stake ever crosses the minds of assisted suicide advocates. Clear thinking seems to evaporate. Logical consequences are obscured by an emotionally charged rhetoric of personal choice, dignity, and human rights, based, for the most part, on hard cases of devastating terminal illness and the fear of excruciating pain.
On May 28, the Daily Mercury published a profile story on Nitschke supporter Kaye Milne, “…[a] 41-year-old mother [who] has had diabetes since she was 11, a vascular disease for the past decade and suffered kidney failure in 2007. Her organs and system functions have been left shattered after she had intense radiation treatment for cervical cancer when she was in her late 20s”. The Mercury reported that “Ms Milne was disgusted by people who said it was wrong for anyone to think about euthanasia. ‘It’s no-one’s right to say you can’t go,’ she said. ‘It made me very angry; it’s my right to go’.”
I do not for one moment wish to trivialise Ms Milne’s suffering. Indeed, I have no doubt that her desperation, fear and anger are entirely justified by years of physical, psychological and emotional strain. But I must take issue with Ms Milne’s insistence that she has a “right to go”.
The “right to go” is the catchcry of the assisted suicide movement. Personal autonomy and the right to self-determination dictate that no-one has the right to tell a terminally ill person in extreme pain that they are not allowed to end the pain by killing themselves.
But logical extrapolation of the principle brings us to some jarring and unsavoury conclusions. If Ms Milne has a “right to go”, does everyone have that right? Nitschke’s track record would seem to suggest that, yes, everyone who “understands death” has a right to commit suicide. Or, to use the seductively harmless language of the suicide movement, everyone has a right to choose a dignified end, at a time and in a manner of their own choosing.
A fellow I know committed suicide several years ago. Some years earlier he had experienced the tragic death of a family member. He had struggled with depression. He was dazzlingly intelligent, well versed in philosophy, and talented in many ways. His determination to die was tragically well reasoned. His was a rationally contemplated course of action. He attempted suicide on several occasions. Eventually, he succeeded. He was 16.
I wonder whether Dr Nitschke, if pressed, would defend this tragic loss of young life as a reasonable exercise of the right to die?
See, if the “right to die” were to really gain traction, there is no question that more people than just the terminally ill would claim it as their own. And what inference can we expect the nation’s youth to draw from the work of Dr Nitschke other than that suicide is a right which meddling citizens should not interfere with?
For Nitschke, youth suicide may be a tangential issue, and therefore not his problem. But that doesn’t mean it’s not our problem. And that gives us the right to hold Dr Nitschke to account.
Advocates of assisted suicide at the legislative level seek to obfuscate the alarming logic of the “right to die” movement by promising to implement “safeguards”. Like bills which have gone before it, the Tasmanian bill would restrict assisted suicide to the terminally ill, and would require psychiatric assessment of persons who request assisted suicide.
But experience has shown such “safeguards” to be toothless. Legislation operative in the Northern Territory in 1996-7 required assisted suicide candidates to be terminally ill, and yet a review in medical journal The Lancet revealed that one of the few men to die under the legislation was not in fact terminally ill. The same review revealed that psychiatric assessment of seriously ill persons is rarely conclusive and is fraught with uncertainty. Candidates under review exhibited symptoms of depression and isolation, and yet all passed the required psychiatric assessment.
In Oregon USA, so-called safeguards are simply ignored, as a journal article published last year in the Michigan Law Review demonstrates. The article identifies imprecise and reckless psychiatric assessment of patients, clear cases of coercion (both direct and indirect), and a lack of attention to proper physical, psychological and personal care in improving quality of life and eliminating suicidal tendencies among the terminally ill.
Quite apart from their impotence, safeguards simply impose arbitrary limits on the “right to die”. For persons who fall outside the arbitrary limits, safeguards are in fact a form of discrimination, acknowledging the “right to die” in some, but not others. As a result, safeguards are inevitably whittled away.
The Netherlands is a telling case in point. There, assisted-suicide was legalised with “safeguards” in 2002. Now Dutch law expressly protects the “right to die” not just the for the terminally ill, but also for the disabled and the depressed. Dutch euthanasia law has even been expanded to allow the killing of seriously ill newborn babies.
If we are to draw any conclusions from the success of Nitschke’s suicide road show, it is that a growing number of Australians, and particularly elderly Australians, are fearful enough of the process of dying that they are willing to contemplate suicide. We can either give them a shove as they stand on the precipice, or take their concerns seriously by acknowledging the importance of end-of-life care.
Societies past have considered it a duty to coax the suicidal from the brink of tragedy. Our duty is no different. Our legislators must reject suicide as a solution to end-of-life suffering. At a time when palliative medicine is better than ever, they must explode the myth that a painful, protracted death is unavoidable, and make end-of-life care a top priority.
– Tim Cannon works as a research officer with the Australian Family Association.