September 25, 2017

Dead right: Philip Nitschke condemns our ‘prehistoric’ euthanasia laws

The Big Smoke Australia by Ingeborg van Teeseling

With the topic of legalising euthanasia up for debate in parliament this week, I travelled to Holland to speak to the man who started the conversation.

You have been putting up with portraits of often long-dead Australian mavericks from me for weeks now, as part of my attempt to entertain and inspire. This time, though, our maverick is alive and well and willing to talk. And there is plenty of reason for a conversation, because the cause he spent most of his life advocating, euthanasia, will be debated in both the NSW and Victorian parliaments this week. In fact, it is on the agenda in Sydney today. But Philip Nitschke won’t be there. Two years ago he migrated to the more liberal climes of the Netherlands and that is where we are talking now, in a high-ceilinged restaurant dating back to the 18th century, with heavy wood paneling, landscapes painted on walls and waiters in long white aprons. But there are reminders of home too, like the cockatoo on the bar, a gift from an Australian sailor 22 years ago and still on his perch overlooking the customers, screeching his comments. Nitschke turned 70 this year and although he takes his cause very seriously, he knows how to have a good laugh at his own expense. “When I helped my first patient kill himself, Wikipedia started referring to me as ‘doctor death’. There are only nine of us. Six are dead. People like Mengele, the Nazi doctor in Auschwitz, and Jack Kevorkian. Then there is a chap in Siberia who is serving a life sentence, somebody in South Africa awaiting trial for murder, and me. Last man standing.”

Nitschke seems at home in Holland. A few days ago he was on the front page of one of the leading Dutch papers, talking about a new euthanasia drug. But he is not a controversial, polarising figure here; just another expert giving his measured opinion about the way forward in the debate. The euthanasia debate in the Netherlands has been raging since the early 1970s and resulted in a law in 2002 that allows for close to what the Australian states are discussing now. The discussion in Holland at the moment is about giving people the right to decide for themselves whether they want to die or not, without the interference of a doctor, and even without the necessity of a terminal illness. The majority of the country, 74%, is in favour of supplying people who feel their life is “completed” with a pill that they can use if and when they decide it is time to end it. It is a conversation that is a long way from the one in front of the Australian politicians this week, and Nitschke deplores the fact that the country is so far behind most of the rest of the Western world. Especially because Australia was the first to have a euthanasia law in the world, in the Northern Territory in 1996. Nitschke himself was instrumental in getting it passed and making it work until the Federal government shut it down.

What NSW and Victoria are talking about now he views as “prehistoric. I understand, of course, that it is better than nothing. But in the rest of the world the drive is to see euthanasia as a right, not a privilege. A privilege dependent on doctors, who will be reluctant to surrender it later on. Look: we live in a world that is being run by the baby boomers. These are people who are used to getting their own way, running their own lives. A lot of the women have gone through political battles around abortion rights, feminism, the Pill. They don’t want to be told how to live or how to die. The idea that you can pat these people on the head and say ‘there, there, let the doctors decide’ is frankly ridiculous. In 2003 I was confronted with a retired academic, Lisette Nigot, who asked me to help her. She wasn’t sick, but she was old and didn’t want to get any older. I was umming and ahing, because there was nothing physically wrong with her. She got very angry at me. ‘I came for information, not a sermon’, she told me, and asked me what right I had to judge other people’s lives and motivations. Suddenly I realised that I was behaving like the government, being paternalistic and censoring people. It completely changed my thinking about euthanasia. People’s lives are people’s lives. Death is a part of that, and so it should be up to them to make the decisions.”

Philip Nitschke is 70 now and the cause of euthanasia has been his life since 1996. I wanted to write “part of his life”, but that would be understating it, because he has been living and breathing the issue almost 24/7 for more than 20 years. But it didn’t start like that. Born in the very small South Australian town of Ardrossan, he was the first in his family to go to university, gaining a PhD from Flinders University in laser physics in 1972. A little more to the north, Vincent Lingiari had led his Gurindji people in a protest against work and conditions at Wave Hill cattle station a few years before. The Gurindji were camping at Wattie Creek, demanding their land back, and Nitschke went up to see if he could help. He stayed and that changed his life. Because he was the only person who could read and write, it was his job to fetch the mail from the bi-weekly plane and read it to the assembled elders. Then they would sit, discuss and deliberate an answer, which Nitschke would write down and send away. “I learned a lot from my time there. About saying ‘no’, dealing with conflict, with hardship. The situation there was horrendous. After six, seven years of strike and living in a dry riverbed, half the camp had leprosy. I had never seen anything like it. But it was about injustice and Lingiari had an impressive way of handling the conflict. He was able to bring people together, giving everybody the idea that they were valued and listened to. In the end I had to leave, but it gave me the training and the stamina I needed for my life as a euthanasia campaigner.”

For a while, Nitschke worked as a ranger in the NT, until he was hit in the head by an eski on the back of a truck, which caused him to fall off and break his heel. A life-long limp was the result, but also some compensation money, which he used to study medicine. When euthanasia became a political issue in the NT in 1995, he had been working as a GP in Darwin for six years. To Nitschke it seemed like a no-brainer, so the push-back surprised him. “Especially the southern states were furious. ‘You can’t do that’, they said, ‘nobody has ever done that anywhere in the world’. To Territorians that was a sign they were on the right track. This is a special part of Australia: secular, full of people who have run away from other places and like to see themselves as different and better than the rest of the country. They love giving the finger to the world. I think that was one of the reasons why the law was passed.” But then, as now, the powers-that-be put up a fight. Churches, politicians, doctors were opposed. The Australian Medical Association vowed that no doctor would have anything to do with it. That irked Nitschke, who managed to find 20 doctors and take out a full-page ad in the paper, telling the punters that they, in fact, would help patients die. It got the law over the line, but that was only the beginning.

The first person to test the law with his life was taxi driver Max Bell, who had driven from Broken Hill to Darwin to be able to die in peace. Nitschke had promised to help him, but however hard he tried, he could not find the specialist the law deemed necessary to sign the required paperwork. After three weeks, a dying Bell had to drive himself back to his hometown, where he died in a hospital not long after. “Max was a martyr for the cause. He had been filmed by ABC’s Four Corners and when the program was broadcast, I received a phone call from somebody who wanted to help ‘if you ever get another patient’. That was Bob Dent. By that time I had built a machine that gave him the opportunity to push the button and administer the drugs himself. He died in his wife’s arms, while I watched from a corner of the room, relieved that it had all worked the way we planned. Two more people would follow Bob before the government shut us down. And I knew my life would never be the same again.”

Between 1996 and 2014 Nitschke focused on advising people on medication and other ways to end their lives. He established Exit International and wrote books like the Peaceful Pill Handbook, that was blacklisted by the government, while its website was refused classification and banned from the Internet. Nitschke is cynically proud of it: “The only book they banned in 30 years. That is something special, isn’t it?” There were police raids too and both Nitschke and his staff and supporters were regularly harassed. Whenever somebody died by their own hand, Nitschke seemed suspect number one. Of course, the good doctor did not step away from controversy. He sought the attention of the media, built thought-provoking machines to help people end their lives and assisted them to find medication abroad. Then, in 2014, it all came to a head when a man called Nigel Bradley killed himself after talking to Nitschke during and after an Exit International meeting in Perth. Other doctors complained to the Medical Board, which used its emergency powers to de-register him, stating that he presented “a serious risk to public health and safety”. There was an appeal and in the end Nitschke won. But it had cost Exit $300,000 and the Medical Board only agreed to give Nitschke his medical licence back if he adhered to a whole list of conditions. “I had to practice under supervision, report every week to the police, take my name off my books and refrain from ever informing people about euthanasia again.” He refused. Instead, Philip Nitschke burned his licence and “felt much better after that. It was an enormous relief, something I should have done a lot earlier.”

At the moment Nitschke is happy on his houseboat on a canal in Holland. He has just built the “Sarco”, a smart little car-like contraption set up to give its temporary inhabitants a peaceful and even euphoric death, after which they can be buried in situ. “Free for everybody with a 3D printer. It doesn’t even require illegal sources.” He also found a way to assess the quality of people’s Nembutal, by engaging a Spanish laboratory to test the mostly Chinese suppliers. But most of the time he organises conferences or updates and upgrades the books, that are available online in more and more languages. And then there is still Exit International, now an online as well as a live forum, where people share information and try to help each other out. While the cockatoo tries to bite off the hand of an unsuspecting Dutchman, I ask Philip Nitschke if he can imagine a time without the cause of euthanasia determining his life. He looks at me in disbelief. “Let me show you a picture of the new machine. We will present it in Toronto in a few weeks. It looks really, really cool.” That is how we like our mavericks. Determined, obsessed, convinced of their causes.