![\"Economist](\"https:\/\/www.peacefulpillhandbook.com\/wp-content\/uploads\/2019\/12\/Economist-2-620x773.jpg\")
<\/p>\nIt\u2019s a sunny autumn morning in the Jordaan, Amsterdam\u2019s chocolate-boxiest district. Over tea in a modishly renovated maisonette, a voluble Australian 72\u00a0year-0ld wearing round glasses and fashionable denim is regaling me with his new-year plans, which involve \u201can elegant gas chamber\u201d stationed at a secret location in Switzerland and \u201ca happily dead body\u201d.<\/p>\n
My host\u2019s name is Philip Nitschke and he\u2019s invented a machine called Sarco. Short for sarcophagus, the slick, spaceship-like pod has a seat for one passenger en-route to the afterlife. It uses nitrogen to enact a pain-free, peaceful death from inert-gas asphyxiation at the touch of a button. With the help of his wife and colleague, the writer and lawyer Dr Fiona Stewart, Nitschke is ushering the death-on-demand movement towards a dramatic new milestone \u2013 and their enthusiasm is palpable.<\/p>\n
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\u201cWe\u2019ve got a number of people lined up already, actually,\u201d says Nitschke, whose unique CV (and previous occupation as a registered physician) has earned him the nickname \u201cDr Death\u201d. The front-runner in the one-way journey to Switzerland is a New Zealander whom Nitschke has known for years.<\/p>\n
She\u2019s not terminally ill, but is becoming increasingly disabled by macular degeneration \u2013 something she finds intolerable after a lifetime of reading for pleasure. \u201cShe\u2019s also got an ideological, philosophical supportive commitment to the idea,\u201d explains Nitschke. \u201cShe\u2019s coming from a long way because she likes the concept and she sees it as the future.\u201d<\/p>\n
Whether that future is utopian or dystopian depends on your perspective. Nitschke has twice been nominated for Australian of the Year for his work with Exit International, the \u201cend-of-life choices information and advocacy organisation\u201d he founded in 1997; activities include the publication of The Peaceful Pill, a continuously updated directory of information on how to end it all. But over the past two decades, members of the medical, psychiatric and even the pro-voluntary euthanasia communities have come to reject his brand of increasingly strident \u2013 some say extreme \u2013 advocacy for what he terms \u201crational suicide\u201d: an individual\u2019s inalienable right to die in a manner of their choosing.<\/p>\n
His one time ally, the former UN medical director Michael Irwin, has branded him \u201ctotally irresponsible\u201d for telling people how to obtain drugs that could help them end their own lives. And in August 2019 the grieving daughter of a man who took his life after contact with Exit International denounced Nitschke, saying \u201cthe information you put out kills people who are not in a rational state of mind to make that decision.\u201d<\/p>\n
Nitschke says he doesn\u2019t want \u201cto make a load of money from it,\u201d but there\u2019s Silicon Valley swagger in his latest project\u2019s ambition to disrupt the business of elective death through technology. The Sarco concept came to Nitschke while watching “Soylent Green”, a 1970s sci-fi movie in which Charlton Heston, disgusted by a world ravaged by global warming, seeks euthanasia in the serenity of a customised government clinic. It\u2019s set in 2022. Eventually, Nitschke wants the 3D-printed Sarco to be accessible on demand to anyone, anywhere \u2013 a sort of cosmic Uber into the great beyond. But for now, he\u2019s taking his invention to Switzerland because it\u2019s the only jurisdiction worldwide in which, \u201cso long as there\u2019s no malicious purpose\u201d, assistance in a suicide is not a crime.<\/p>\n
Nitschke and Stewart are much jollier than you\u2019d expect the right-to-die movement\u2019s only power couple to be. They\u2019re full of \u2013 well \u2013 joie de vivre and arch banter about everything from Brexit to the roadworks that have denuded the front of their home of a beloved creeper. \u201cIf it\u2019s not dead, boy is it doing a bloody good impression of being dead,\u201d observes Nitschke, correctly.<\/p>\n
Stewart is at the kitchen table, processing applications from her laptop, and asking correspondents for proof of age. Officially, membership to Exit is restricted to the over 50s, and its members are mostly in jurisdictions where neither assisted suicide nor euthanasia are available \u2013 which is to say, most of the countries in the world. \u201cI\u2019m the door bitch,\u201d she jokes.<\/p>\n
Stewart had been a pro-choice advocate in Australia before meeting Nitschke at a festival of ideas in Brisbane in 2001.\u00a0Later, she would be horrified by the state of his nascent organisation. \u201cShe said, \u2018This is a mess \u2013 you\u2019re not paying enough tax, your business is a shambles and it needs proper management.\u2019\u201d says Nitschke. \u201cShe turned the whole thing around. I can\u2019t do much without her.\u201d
\nOne of those opposed to Sarco is Paul Biegler, adjunct research fellow at the Monash Bioethics Centre in Victoria. \u201cYou can make an argument that people have got a right to control the time of their death,\u201d he tells me over Skype, later. \u201cYou could make an argument that rational suicide in the absence of a terminal illness is a defensible option for some people. But it really is a quantum leap to go from saying that people have a right to choose the time and nature of their dying to providing a mechanism for that to happen.\u201d<\/p>\n
A comprehensive assessment of worldwide data in 2016 showed that, in areas where euthanasia or physician-assisted suicide are legal, 0.3-4.6% of deaths result from them, with more than 70% of cases involving patients with cancer. The report described these numbers as an indication that despite growing legalisation the practice \u201cremains rare\u201d. The Netherlands\u2019 relatively permissive law stipulates that to qualify for either procedure an applicant must be shown to be experiencing \u201cunbearable suffering from which there is no prospect of recovery\u201d with \u201cno reasonable alternatives\u201d available to end that suffering.<\/p>\n
It has been criticised for not making a distinction between physical and mental distress, which could, in theory, justify euthanasia for psychiatric patients. Switzerland\u2019s law is looser \u2013 foreigners can travel there and legally access physician-assisted suicide. The only two legal requirements a candidate is required to satisfy are the intention to end their life and soundness of mind. \u201cThe general approach [for the latter] has been to get a ticket of approval from a psychiatrist,\u201d notes Nitschke.<\/p>\n
The Sarco project bore fruit at the same time as subtle legal developments in Switzerland. Although there\u2019s nothing in Swiss law to state that a person must be terminally ill to be eligible for assisted suicide, in practice, says Nitschke, \u201cgroups such as Dignitas have chosen to further medicalise the legislation,\u201d he says, \u201cbecause the only way they could get a doctor to prescribe [the lethal dose of the barbiturate] Nembutal was for the person to say they were sick.\u201d<\/p>\n
This, he thinks, is specious and evidence of the medical profession\u2019s creeping paternalism, which he finds abhorrent. \u201c[Doctors are] always there, setting themselves up as the gatekeepers when it comes to areas of human endeavour that they should have no role in \u2013 because when you medicalise something you\u2019ve got to have a medical controller,\u201d he says.<\/p>\n
The great irony of Nitschke\u2019s career, in his view, is that he seems to spend as much time \u201carguing with people on my own side\u201d as he does weathering the rebukes of \u201cthe born again Christians.\u201d He recalls being denounced by Dignity in Dying (in its former incarnation as the Voluntary Euthanasia Society) after he was detained, then released, by authorities at Heathrow airport on his way to host Exit workshops in the UK whilst carrying equipment for testing the safety of Nembutal, the barbiturate most often used for lethal injections, which terminally ill individuals were starting to obtain online from questionable sources.<\/p>\n
\u201cThey came out and said I was a danger to the movement. I found that annoying but I suppose what we were seeing was a difference in philosophy. I was telling people: get your own drugs, test your own drugs, be in control; they were saying: change the law, convince the politicians…\u201d<\/p>\n
It\u2019s undeniable that Nitschke\u2019s campaigns have exhibited a certain PR-savvy pizzazz. He is the originator, no less, of the euthanasia flash mob, which took place to celebrate his 70th birthday and 20 years of Exit International (soundtrack: Bon Jovi\u2019s “It\u2019s My Life”, naturally). When he announced plans for Sarco, it was dismissed by some, says Nitschke, as \u201ca stunt, or some virtual creation in someone\u2019s mind that didn\u2019t have any prospect of physical reality.\u201d<\/p>\n
I can attest that the machine exists, having had the singular experience of reclining on a prototype at Nitschke\u2019s workshop on an industrial estate in Hillegom, South Holland, amidst the incongruous spring blaze of the tulip fields. Plus, scratch the surface of his provocative patter and there\u2019s a person \u2013 a patient \u2013 lurking behind each of his convictions.<\/p>\n
Even aged 18, Nitschke demonstrated a flair for taking the law into his own hands after thieves stole the radio from his car, which was parked outside a dance. The police told him it was too small an affair to pursue so Nitschke spent two Saturday nights hiding in the boot with a .22 caliber\u00a0rifle waiting for the thief to return. They did, and Nitschke marched them to a telephone and called the police, who arrested the thief and retrieved the stolen transistor.\u00a0\u201cYou should solve your own problems is how I\u2019d put it,\u201d says Nitschke.<\/p>\n
Nitschke studied physics at the University of Adelaide before heading to the Northern Territory to work as an Aboriginal land-rights activist. Having studied for his medical degree with, he says, the intention of \u201ccuring himself of hypochondria,\u201d in 1996 he became the first doctor in the world to administer a legal, lethal voluntary injection under the short-lived Rights of the Terminally Ill Act which, astonishingly, made the statute books in the Northern Territory by one vote.<\/p>\n
![\"Economist](\"https:\/\/www.peacefulpillhandbook.com\/wp-content\/uploads\/2019\/12\/Economist-1-620x776.jpg\")
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\u201cSuddenly we had a law which meant terminally ill people could legally seek help from a doctor to die,\u201d he recalls. \u201cAnd when a patient came to me who was eligible, because he was dying of prostate cancer, as much as I was passionate about his right to die, I didn\u2019t want to be the one to do it, you know, so I built a machine that would downgrade euthanasia into assisted suicide. I would load it up and put the needle in the vein, all that stuff, but he was the one pressing the button.\u201d<\/p>\n
That patient\u2019s name was Bob Dent and Nitschke\u2019s invention, the Deliverance Machine \u2013 listed on the Wikipedia page for notable euthanasia devices in history and now on display in London\u2019s Science Museum \u2013 lasted eight months and ended the lives of three more people before the law was overturned and assisting in a suicide became a serious crime again.<\/p>\n
\u201cThe other important aspect of the Deliverance \u2013 and this certainly doesn\u2019t apply to Sarco \u2013 was that it meant the user was able to die in his wife\u2019s arms,\u201d says Nitschke. \u201cThe machine didn\u2019t take up much space so he was able to press the button, push the machine away and hold his wife,\u201d his usually robust voice crackles. \u201cI was on the other side of the room,\u201d he says.<\/p>\n
Initially, Nitschke ran Exit workshops exclusively for the terminally ill. His self-described \u201cbig, blinding road to Damascus change\u201d came courtesy of a French academic from Perth named Lisette Nigot, whom Nitschke met in 1999 when she was 76. She had no desire to live to see 80, and repeatedly approached Nitschke asking for information about suicide drugs.<\/p>\n
\u201cI always said to her, that\u2019s ridiculous: you\u2019re not sick, go on a world cruise or write a book. And one day she said: \u2018Mind your own business. I make this decision \u2013 you run around imposing your template on other people of what a life worth living is and dole out your information only to those people you think meet your criteria. You\u2019re the worst example of insufferable medical paternalism I\u2019ve ever met.\u2019\u00a0I immediately crumpled and fell apart and agreed with her. It really affected me.\u201d<\/p>\n
There\u2019s a photograph of Nigot \u2013 whose 2002 suicide-note declared Nitschke to be her inspiration \u2013 on the wall of the workshop in Hillegom.<\/p>\n
Nitschke developed Sarco with the help of Haarlem-based industrial designer Alexander Bannink. \u201cMy original design looked more like a bathtub,\u201d says Nitschke, \u201cwhereas Alexander really pushed the idea of making it resemble a vehicle, to give the sense of going somewhere.\u201d Engaging suppliers for the project has been interesting. \u201cWhen we first went to see a company down in Vlaardingen about building these strange aluminium tanks, I said to them, I\u2019m building some sort of death machine, do you want one of your logos on the side of it?\u201d They declined.<\/p>\n
Sarco\u2019s raison d\u2019\u00eatre, admits Nitschke, is aesthetic. It obviates what he calls \u201cthe yuck factor\u201d inherent in other tools of \u201cpeaceful\u201d suicide, such as the humble plastic bag and gas. \u201cThat\u2019s just as efficient,\u201d he says. \u201cYou can tell people over and over and over, as I do in my workshops, that it\u2019s cheap, reliable, quick and legal, but they say, I don\u2019t care if it\u2019s a peaceful death, I do not like the look of it and I don\u2019t want to be found like that.\u201d<\/p>\n
![\"Sarco](\"https:\/\/www.peacefulpillhandbook.com\/wp-content\/uploads\/2019\/12\/Sarco-in-room-2-2-620x413.jpg\")
<\/p>\n
Sarco, meanwhile, is positively Instagrammable. A sleek conveyance that wouldn\u2019t look out of place in a Tesla showroom, it consists of a detachable capsule \u2013 a coffin, essentially \u2013 mounted diagonally on a stand. Once inside, its user presses a button, prompting the release of nitrogen from a store-bought canister. \u201cFrom a physiological point of view, it is peaceful,\u201d says Nitschke. \u201cIt\u2019s not the same as a rope around the neck, a pillow in the face or a head underwater \u2013 these are mechanical obstructions to breathing and they\u2019re terrifying, let me tell you.\u201d<\/p>\n
Unlike previous Nitschke-devised death technologies, Sarco does not require the procurement or prescription of drugs. This is handy because Nitschke is no longer a doctor, having publicly burned his medical licence in 2015 following a dispute with the South Australian chapter of the Medical Board of Australia. It suspended Nitschke before offering to reinstate him providing he fulfil 26 criteria which included refraining from talking about euthanasia. Shortly afterwards, Nitschke and Stewart moved to the Netherlands on an entrepreneurial visa.<\/p>\n
Then came the elective death in May 2018 of Nitschke\u2019s friend, the 104-year-old botanist David Goodall, who refused to declare any serious condition beyond being \u201ctired of life\u201d but was nevertheless allowed to kill himself by lethal infusion at the Life Circle facility in Basel. \u201cThat set a precedent,\u201d says Nitschke.<\/p>\n
Nitschke and his lawyers began the process of setting up what he vaguely calls \u201can organisation\u201d in Switzerland to facilitate the use of Sarco for those who want to end it all for whatever reason. For now, he\u2019s keeping the specifics of the facility and its whereabouts close to his chest for fear of sabotage, but he says he\u2019s been talking to amenable local psychiatrists \u2013 whose participation he\u2019ll need because the \u201csoundness of mind\u201d criterion still stands \u2013 and is confident of success.<\/p>\n
It\u2019s late November \u2013 Black Friday, in fact \u2013 when I call Nitschke on his mobile for an update. He and Stewart are on the road with Sarco in tow, having retrieved a display model from a flooded Venice, where it has been on show at the Palazzo Michiel as part of the Venice design festival since May (pictured above).\u00a0\u201cIt was bloody awful,\u201d he says of the devastation in Venice. \u201cFortunately Sarco was on the palazzo\u2019s first floor, but still it had to be carried by people wearing thigh-high waders, put on a barge and floated out of the place.\u201d<\/p>\n
I ask whether Nitschke is feeling nervous about a debut for which there can, after all, be no dress rehearsal. \u201cThere is a great deal of apprehension and nervousness,\u201d he affirms, \u201cand I can sense it building now as I watch the calendar days ticking down. I\u2019m getting more and more anxious about it because I well and truly recognise that there\u2019s a lot hinging on this for other people whose wishes are very important to me and, while I want things to run smoothly there\u2019s always the possibility of some bizarre eventuality you can\u2019t predict. But once I\u2019ve got the comfort of seeing the successful initial uses of the machine I think I\u2019m going to be very pleased indeed.\u201d<\/p>\n
![\"Sarcooktober2018v2.352\"](\"https:\/\/www.peacefulpillhandbook.com\/wp-content\/uploads\/2019\/12\/Sarcooktober2018v2.352-620x349.jpg\")
<\/p>\n
He suspects the reaction against Sarco has been so strong because the whole ethos of the device \u201cflies in the face of the current Western paradigm, which dictates that all human effort and endeavour should be directed towards living longer at all costs, and any death is perceived as some fundamental failure that must be conducted shamefully, privately and in secret.\u201d<\/p>\n
He thinks technology is affording us the opportunity to consider how the end of life might be reframed \u201cas a cause for some celebration or at least a momentous event, as it has been regarded by other cultures and in times gone by\u201d.<\/p>\n
I ask the obvious question: what a successful death might look like in his own case. It would depend, he says, on the circumstances.\u00a0\u201cBut I know what I don\u2019t want. I don\u2019t want to be stuffed full of tubes with doctors hovering over me, pleased with themselves for keeping my heart beating for another five minutes, eking out every last painful second. That, to me, is dystopia.\u201d<\/p>\n
Mark Smith is a freelance writer based in Amsterdam<\/em><\/p>\n Photos: Sem Langendijk<\/em><\/p>\n","protected":false},"excerpt":{"rendered":" It\u2019s a sunny autumn morning in the Jordaan, Amsterdam\u2019s chocolate-boxiest district. Over tea in a modishly renovated maisonette, a voluble Australian 72\u00a0year-0ld wearing round glasses and fashionable denim is regaling me with his new-year plans, which involve \u201can elegant gas chamber\u201d stationed at a secret location in Switzerland and \u201ca happily dead body\u201d. My host\u2019s<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[1],"tags":[],"yoast_head":"\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\t\n