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The Exit Internationalist

December 5, 2017

Meet the Elon Musk of Assisted Suicide

Newsweek, Nicole Goodkind

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Meet the Elon Musk of Assisted Suicide, Whose Machine Lets You Kill Yourself Anywhere

Dr. Philip Nitschke considers himself the Elon Musk of assisted suicide—and his latest death machine, the Sarco, is his Tesla.

Newsweek spoke with the 70-year-old doctor immediately after the state of Victoria in Australia, his home country, voted this week to legalize euthanasia. Many are billing this as the first law of this nature Down Under, though Nitschke performed his first assisted death in 1996, during a brief period of legality in the country’s Northern Territory.

As a young medical school graduate, Nitschke found himself drawn to the world of euthanasia and the work of Dr. Jack Kevorkian, the most famous euthanasia proponent in the United States. Inspired by Kevorkian’s death machine, Nitschke set out to create an updated version that he called “the Deliverance.” The machine was rudimentary, comprising only a laptop hooked to an IV system, but it worked. A computer program would confirm a patient’s intent to die and then trigger a lethal injection of barbiturates. It successfully ended four lives before Australia repealed the bill that legalized euthanasia in 1997.

But ending legal euthanasia “didn’t stop people from coming to me saying that they wanted to die,” said Nitschke. “I’ve spent the last 20 years fighting for the legislation that just passed.”

Nitschke has aided in hundreds of what he calls “rational suicides.” In 1997, he founded Exit International, a nonprofit that advocates for the legalization of euthanasia, and in 2006, he published the Peaceful Pill Handbook, which instructs on the most painless and efficient ways to commit suicide.

All the while, Nitschke continued to innovate his death devices. He created an “exit bag,” a bizzaro breathing mask with carbon monoxide replacing oxygen. The bag was highly effective but not very appealing, Nitschke said, citing the “plastic bag factor”: People don’t want to leave the world in such an aesthetically displeasing way.

His latest machine, the Sarco, is the answer to that problem. The Sarco is sleek—and, Nitschke stresses, luxurious. It resembles a spaceship and is intended to convince its user that he or she is journeying to the great beyond. Its base contains canisters of liquid nitrogen and a removable capsule compartment that can be repurposed as a casket. The whole operation will be open-source and could theoretically be 3-D-printed anywhere in the world. It is, in short, the Model S of death machines.

Here’s how it works: Potential users fill out an online test of mental fitness, and if they pass, they receive an access code that works for 24 hours. After the code is entered and an additional confirmation is given, the Sarco capsule will fill up with liquid nitrogen to bring the oxygen level down to about 5 percent. Within one minute the user passes out, and a few minutes later, death comes.

Nitschke vowed that a Sarco death was relatively painless—there is no asphyxiation and the user breathes easily, he said, comparing it to an airplane cabin depressurizing. The model is scheduled to become widely available next year, and Nitschke was already in talks with some suicide clinics in Switzerland to license the machine.

Fighting to die

In the past 20 years, the right to physician-assisted suicide has been legalized in Washington, California, Vermont, Oregon and a several European countries. Nitschke believes the change in attitude stemmed from the aging Baby Boomer generation. “I’ve seen a marked difference between generations,” he said. “Boomers want to be in control of their own deaths. They don’t like the idea of someone patting them on the head and telling them what to do.”

But each state and country has its own nuanced set of rules around medical aid in dying, while Nitschke believes the right to die is a human right, not a medical or legal privilege. No one should be subject to rules about whether or not a person is sick enough to choose to die, he said.

It is the “right of a rational adult to have a peaceful death,” he said. “Every person over the age of 70 should be able to die.”

Of course, not everyone agrees with Nitschke. “I think it’s bad medicine, ethics, and bad public policy,” Dr. Daniel Sulmasy, a Georgetown professor of biomedical ethics, told Newsweek. “It converts killing into a form of healing and doesn’t acknowledge that we can now do more for symptoms through palliative than ever before.” Palliative care focuses on improving the quality of lives for people fighting deadly illnesses, rather than ending those lives.

Sulmasy believes assisted suicide violates the bedrock of all ethical thinking, which is that people have value simply by being human beings. He argued that assisted suicide sent a message to disabled and dying people that society believed they should choose death if they became too much of a burden.

He worried about the contagious effect suicide often has, pointing to the rash of suicides that occurred after Derek Humphry published Final Exit, a book that detailed aspects of planning and carrying out suicide. After the book was published in 1991, the number of suicides by asphyxiation in New York City rose by 313 percent that year. Sulmasy also pointed out that in Holland, nearly 5 percent of all deaths are due to euthanasia or assisted suicide.

Doctors can ethically help patients find the ultimate relief in their final days, ethically, through a process called the rule of double effect, Sulmasy said. The rule says that if a patient agrees to the risks, an attending physician is allowed to keep increasing the dosage of pain medication until pain is completely under control, which may mean administering enough to render the patient unconscious or kill them.

Nitschke argued that palliative care wasn’t for everybody. People in good health had approached him simply because they felt that they’d had a good life and were ready to go, he said. He believes they have just as much a right to death as anyone else.

Now a septuagenarian himself, the death doctor is coming to terms with his own mortality. And his invention might be his solution.

“I’ve thought about it a lot lately,” he said. “I am attracted to the idea of the Sarco, and if I find myself in a situation where I need to use, it I will.”

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