November 13, 2014
Dr Philip Nitschke says depressed people can make informed decisions to end their lives
Euthanasia campaigner Philip Nitschke will consider abandoning his right to practice medicine, he has told a Darwin tribunal.
Dr Nitschke said he was fighting a decision by the South Australian medical board to suspend him primarily to defend his reputation and right to fair process.
The Board used emergency powers to suspend Dr Nitschke after media reports he supported a Western Australian man, Nigel Brayley, who was not terminally ill but had decided to take his own life.
Police were investigating the murder of Mr Brayley’s wife when he died. He had also been involved with another woman who disappeared.
Dr Nitschke earlier told the hearing he had no obligation to encourage people who want to end their lives to seek help, even if they do not have a terminal illness.
Barrister Lisa Chapman, acting for the Medical Board of Australia, asked Dr Nitschke whether or not he believed if a person who wanted to commit suicide due to financial difficulties or being tired of life should be directed towards a doctor and be examined for depression.
He said if someone approached him at a meeting of his euthanasia group Exit International and said they did not have terminal illness but wanted to end their life, he would ask them why.
“It’s not for me to come along and second judge and, if you like, frustrate or thwart that person’s plan for their future,” he said. “[But] the reason is relevant – if they said they were going to suicide because it’s the end of the world tomorrow, I would of course engage further.
“To try to draw this connection, this one-on-one connection, that every person who suicides is somehow the victim of a mental illness, is simply incorrect.”
Dr Nitschke told the tribunal he spends most of his time now doing advocacy work, and has only treated about six patients in the past two years, of whom two were new patients.
He said if a patient said they wanted to end their life, he would assess them for depression and refer them on for further help – because they had come to him as a patient seeking treatment from a doctor.
But he believed people with a depressed mood or elements of depression, as long as they were not psychotic or severely mentally impaired, could make an “informed decision” about ending their lives.
Ms Chapman asked him how he could just “switch off” his role as a doctor when acting as a political advocate.
“I’m not switching off … you are effectively saying, because I’m a doctor it must be a medical assessment [when I meet people at Exit International meetings],” he said, adding that such meetings usually involved about 300 people and only cursory meetings.
The president of the tribunal, Kelvin Currie, asked Dr Nitschke if he had become desensitised to the experience of being told by someone that they were considering suicide.
“It’s obviously not a normal experience. I recognise the emails I get every day are not normal emails,” Dr Nitschke said. “It takes away the alarm reaction that people who don’t see these emails often get … and I behave in such a way that some would see as insensitive.”
The tribunal heard that when Dr Nitschke heard Mr Brayley’s life was not “going well” he initially asked him if he wanted to talk about it, or wanted to talk to a medical professional.
But later, during an email exchange, when Mr Brayley indicated he was planning to kill himself soon, Dr Nitschke did not repeat the suggestion he get help. Mr Brayley asked if Dr Nitschke would like to receive a copy of his suicide note, and he said yes.
The medical board maintains that the code of conduct for doctors means they have an obligation to the health of individuals and society at all times.
“You would expect a doctor to conduct his or herself according to that particularly high standard in their general lives,” Ms Chapman told the tribunal.
The hearing concluded Wednesday night.