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Euthanasia products: A step too far?

By Camille Dionisio


In the midst of Australia’s changing legislation on Euthanasia, developments of self-euthanising products continue to spark debate.


With Victoria’s passing of the Voluntary Assisted Dying Scheme in legislation and the NSW government’s refusal to support or follow their lead, it refuelled Australia’s controversy around Euthanasia and products that undermine this legislation.


Meanwhile, Dr Philip Nitschke, Australian ex-physician and Pro-Euthanasia advocate, developed another ‘suicide machine’ called the Sarco with Dutch designer Alexander Bannink.

Credit: Exit International                  Philip Nitschke and Alexander Bannink


Short for Sarcophagus, the product follows its predecessor, Max Dog Brewing, in helping terminally ill and the elderly die without prolonged pain but this time with the provision of a coffin.

Credit: Exit International                                                                   The Sarco (Sarcophagus)


It was launched despite the controversy that arose from his first self-euthanasia invention, Max Dog Brewing, a ‘do-it-yourself’ suicide kit which he marketed as a harmless a home-brewing beer equipment to bypass laws.


His position as the “face of the voluntary euthanasia debate” still stands for two decades as the founder of the global Not-for-profit euthanasia advocacy organisation, Exit International, which has gained traction amongst medical experts, patients, elderly and academics.

Exit logo, Credit: Exit International


Malcolm Parker, Emeritus Professor of Medical Ethics of University of Queensland and was a qualified medical practitioner for thirty years, although a member of Exit International he had mixed views on the legislation:


“This is seen as either a step too far or a step that is far too early. The recent achievement of legislation for assisted dying in Victoria came after long campaigns, deliberations, inquiries etc, and it is described as the world’s most restrictive legislation so far.”


While countries like Belgium have a more liberal Euthanasia legislation and process, Australia evidently wouldn’t have agreed without more boundaries:


“It would not have occurred had it been less regulated, let alone allowing self-delivery techniques not under the surveillance of doctors and numerous conditions,” he said.


Brian Martin, an Exit member and Professor of Social Sciences at the University of Wollongong, highlighted the already accessible means of self-euthanasia through suicide:


“People already have the right to end their lives: suicide is legal. There are numerous legal options for doing it: guns, rope, tall buildings, trains.”


It therefore questions why not just provide a painless mean of death with these products:


“These are all traumatic for the person and/or others. The government has tried to limit access to peaceful means by which people can end their lives.”


Having first-hand insight into Exit International’s audience, he shared that“the primary demographic of people attending Exit workshops is elderly, median age perhaps 75, and/or with a terminal illness,” and in terms of their products of interest, “Nembutal is preferred by most individuals seeking a peaceful death. Using an exit bag is also used, but is less popular,” Martin said.


It answers the underlying concern of potential epidemic public use of euthanasia products when really evident in a small sector of the population.


In reality, statistics show that in countries where euthanasia is legal, it’s not a dominant cause of death but is rather in the low percentiles. Being less than 4% in the Netherlands, less than 2% in Belgium and 0.5% in Oregon.


According to JAMA, just because euthanasia is legal, it didn’t necessarily lead to its widespread abuse. Instead, “Euthanasia and physician-assisted suicide are increasingly being legalized, remain relatively rare, and primarily involve patients with cancer.”


Nonetheless, the right to die has always been a rocky debate considering how accessible these products should be and if it should only be restricted to the terminally ill.


“The most common reason for seeking options for peaceful dying is fear of future suffering when it is impossible, for example due to disability, to voluntarily end one’s life,” Martin said, “Evidence suggests that people with access to means to die peacefully actually live longer, because they do not need to end their lives prematurely to avoid extreme suffering.”


Parker’s experience with the terminally ill and elderly was a “routine experience in general practice,” knowing those who have wanted options for ending their life:


“Motivations include fear of loss of dignity, autonomy, control, meaning to continuing life; fear of painful or otherwise distressing death; unwillingness about being a burden on others.”


Cancer survivor, Karen Alexander, shared the experiences of a terminally ill patient in need of a release from emotional and painful suffering, “over time, I became alienated and isolated from the people I thought would be there for me. I retreated and became a recluse.”


She had acknowledged the desire of those in her position had to end their own life:


“In 6 years, from 2006 till 2012, I often craved to be able to have euthanasia available, just to escape the emotional, and physical trauma from the Doctors and the cancer,” she said, “The physical pain was unbelievable, and the grief I experienced, which was a result of being told I couldn’t have the life I had worked so hard toward.”


Her situation emphasises accessibility concerns in extending to those with mental ailments like depression, considering the potential for successful treatment. Parker had commented, “This is a clinical distinction, given that mental illnesses are clinically diagnosed and treated. Care is required to ensure that existing or proposed diagnoses are not imposed on people who do not have mental illness, but who request assistance to die.”


Overall, accessibility is argued differently as Martin believed that “Logically, they should be at least as available as means for violent death, such as guns,” while Parker condoned their accessibility, but noted that “they should be available but within a regulatory regime.”


According to another Australian Pro-Euthanasia group, Go Gentle Australia, surveys show that 75% of Australians support the legalisation of voluntary assisted dying to allow for a better choice at the end of life.


That Voluntary Assisted Dying is rather another “option alongside palliative care for doctors and patients to explore at the end stage of incurable physical illness,” not intended to “replace palliative care”.


Mrs Jay Anderson, Mental Health Professional of the Mental health practice, My Child My Family, shared her support for Euthanasia, “If an animal is injured or in pain, they are put down…yet, humans are given medications or surgery and expected to keep on going.”


Anderson’s belief as part of a “Christian medical family, where life is respected” also shaped her views on Euthanasia, “But knowing that God would not want people to suffer and that advances on medical technology often keep people living for a lot longer than normal.”


As a mental health professional, she had seen “people with pain and physical illness, cancers and other difficulties such as depression, anxiety or trauma backgrounds,” extending also to those of personal relations:


“My husband has cared for his mother who had cancer for 6 months, as her body deteriorated and she was forced to wait to die ‘naturally’. His elderly father lost capacity to care for himself, refusing a stomach peg to artificially feed him, he was expected to choose to not eat…and slowly die.”


Euthanasia has been known as a taboo subject, yet both Martin and Parker share the view that it’s a vital topic to discuss.


“Because some people have and will utilise this process, it is best that it be recognised, facilitated and regulated, rather than remain underground,” Parker said.