Philip Nitschke and 'rational suicide'

"Suicidal people deserve our care and compassion, not a lethal dose."

Philip Nitschke and 'rational suicide'

Philip Nitschke’s recent suspension from medical practice is only surprising because he has been operating without sanction for almost two decades.


Dr Nitschke’s latest brush with controversy was sparked by his decision to give information to a 45 year-old suicidal man who was not terminally ill, but he has been at this for years.


Nitschke has been involved in many publicised cases of people who were not terminally ill. These include Gold Coast woman Nancy Crick, Lisette Nigot from Perth and Bundaberg couple Sydney and Marjorie Croft. It has recently come to light that two men in their 20s took their lives, Lucas Taylor in 2012 and Joe Waterman last year, after accessing information from Nitschke’s organisation.


All this illustrates euthanasia or assisted suicide cannot be made safe. People in times of crisis are vulnerable and need our support, not a lethal dose.


No law could protect vulnerable people from the threat of euthanasia if it were made available. The law is having a hard enough time protecting vulnerable people now, as these cases clearly show.


We saw that with the failed experiment of euthanasia in the Northern Territory in 1996-97 where Nitschke was the euthanasia doctor. Nitschke co-authored an article in The Lancet that found “Four of the seven cases [of people applying for euthanasia] had symptoms of depression.” The NT experience demonstrated so-called safeguards collapse in the face of desperate people going doctor to doctor seeking someone willing to approve their lethal injection.


On depression, Nitschke says, “the idea that psychiatrists should be the ultimate arbiters does not sit well with me or many of the people that come to see me. I would say common sense is a good enough indicator. It’s not that hard to work out whether you are dealing with a person who is able to make rational decisions or not.” But it is difficult for professionals to assess whether a person is depressed, especially if they have a terminal illness.


Over the years, euthanasia advocates have moved from lobbying for a lethal injection for people with a terminal illness to advocating the same for the so-called hopelessly ill and now to doing so for what they call rational suicides.


More than ten years ago, Nitschke told National Review Online, “someone needs to provide this knowledge, training, or recourse necessary to anyone who wants it, including the depressed, the elderly bereaved, the troubled teen”.


Last year he said, "we might find people at the age of 20 saying, 'I am not in any treatable way affected by a psychiatric malady, and I want to die.' Now I don't think we should be stopping those people. If we can't fix a person, we shouldn't be saying we are going to keep you in some kind of safe house until you see the benefits and joys of existence."


So where is this campaign for euthanasia going? We can see the dangers in Belgium, where in 10 years legal euthanasia has moved from being reserved for terminally ill people to now covering children and dementia patients.


Here, too, Nitschke is on the record supporting child euthanasia, saying, “the Belgians are to be applauded for their progressive thinking”.


In Belgium there are five deaths by euthanasia every day. A study reported that almost one third of cases of euthanasia in Flanders were without explicit consent. Another study found only half the euthanasia cases are reported as the law requires.


Suicidal people deserve our care and compassion, not a lethal dose. Care and compassion mean working with people to find the source of their fear, pain, sadness or depression so that we can help them overcome these difficult challenges. The solution is not to remove the person, but to deal with the problem.


There's nothing dignified about dying because you feel there are no better options. We need to provide the better options, not co-operate in a person's desperate suicidal act.


Palliative care can provide many of those better options. No patient receiving competent palliative care should be in pain. Good doctors and nurses can relieve symptoms. If you or your loved one is not getting good palliative care, get a better doctor.


GPs too need to be alive to the possibility that their patients don’t know about palliative care and they need to ensure a referral when appropriate.


Most importantly, governments need to make sure palliative care is available. Patients often don’t have good access, especially if they live in a regional area.


The Medical Board’s suspension of Philip Nitschke highlights the dangers. Neither euthanasia nor assisted suicide can ever be safe.


Jeremy Stuparich is Public Policy Director for the Australian Catholic Bishops Conference. If you are in a crisis and need help, call Lifeline on 13 11 14, 24 hours a day, seven days a week.


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