Death for sale is a step into the dark

Dr Philip NitschkeWhatever you may think of the Australian euthanasia activist Philip Nitschke, you have to admire his progressive use of technology. Just the other day he said he was encrypting emails to avoid government surveillance. And his advice on how to buy lethal poisons in Mexico and manufacture a lethal barbiturate, as disclosed on the TV program Four Corners, would be impossible without the internet. He has even posted his do-it-yourself suicide manual, The Peaceful Pill, on Google Books. In it you will find instructions on how to kill yourself with plastic bags, carbon monoxide, cyanide, morphine, homebrew nembutal, and so on. In line with cutting-edge trends in internet commerce, Nitschke is bypassing the medical profession's monopoly on death management and putting free open-source technology in the hands of consumers. His fans must feel the same thrill as Linux users defying the Microsoft behemoth. Nitschke is a progressive in his business philosophy as well. When he helped several Northern Territorians to die a decade ago, euthanasia was defended as a way of ending unbearable pain. With good palliative care, deathbed torment is largely a thing of the past. There may well be discomfort and lack of control, but not excruciating pain. Nitschke's genius is to have nimbly adapted to the new medical environment. Now he mainly services people who are tired of life. In effect, Nitschke has reinvented himself as an internet suicide provider.

Nitschke doesn't seem to worry much about whether his clients are depressed or demoralised or socially isolated or lonely. It's not part of the job description of internet suicide providers. They just fill orders, more like warehouse clerks than Marcus Welby, MD.
There is a downside to technological change. Making suicide another consumer good depersonalises medicine. Nitschke doesn't seem to worry much about whether his clients are depressed or demoralised or socially isolated or lonely. It's not part of the job description of internet suicide providers. They just fill orders, more like warehouse clerks than Marcus Welby, MD. So Nitschke gets full marks for being progressive and entrepreneurial. But why is his campaign regarded as a socially progressive cause like refugees, climate change and bringing David Hicks home? Remember, the biggest government ever to endorse voluntary euthanasia was Hitler's Germany. In fact, the dialogue in the maudlin Nazi film Ich Klage An (I Accuse) sounds a lot like Nitschke's reports of his clients' deaths. Not a very progressive precedent. It's also odd because the "progressive" tag hardly suits euthanasia as an impersonal retail transaction. A few years ago Nitschke advocated putting his suicide pills on supermarket shelves. They would provide a peaceful death for anyone who wanted it, "including the depressed, the elderly bereaved [and] the troubled teen". This is not a view that he has repudiated. In his 2005 book Killing Me Softly he included prisoners among the potential beneficiaries, mooting voluntary euthanasia as "the last frontier in prison reform".
Killing Me Softly is an activist's manifesto, not a philosopher's treatise. It's not fair to wring sentences dry for consistency and logic. But when Nitschke deals with the economics of euthanasia, he seems to be taking a firm and unequivocal stand. He emerges as a flint-hearted economic rationalist, not a bleeding heart progressive. Euthanasia would be a good way to trim fat from government budgets, he argues. End-of-life care is expensive. If voluntary euthanasia lopped a mere six months off the lives of ailing elderly, immense savings would result.

"One can but wonder when a government will have the guts to stop digging the fiscal black hole that is their ever-deepening legacy for future generations. While the enabling of end-of-life choices will not fix the economic woes of the next 40 years, it would not hurt, given half a chance. So the next time you hear a government minister trying to argue why this or that payment or welfare program for single mothers or war veterans must be cut, counter their argument with their fiscal irresponsibility on end-of-life choices."
The 18th-century satirist Jonathan Swift proposed to solve food shortages in Ireland by roasting and boiling surplus Irish babies. But he was joking. Nitschke is not joking.
Is this the mellow voice of progressive compassion? Surely not. It sounds more like the gravelly voice of the "compassionate conservativism" so beloved of US neocons, the guys who brought democracy to Iraq, along with thousands of civilian deaths. Death has lost its existential meaning for Nitschke. Instead it has become an opportunity to market books about his lethal gizmos over the internet. This is not a future that  progressives anywhere should want to be part of. Michael Cook is editor of the international bioethics newsletter BioEdge and MercatorNet. This article was first published in the Sydney Morning Herald. 


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