A group of euthanasia supporters is working on
the development of a suicide pill.
The Dutch Supreme Court Judge Huib Drion was the first person
in the world to call openly for the introduction of a pill that
would provide a peaceful, pain-free death at a time of a person's
individual choosing - a pill that is taken orally and available
to "most" people.
Drion wrote to a Dutch newspaper about his own frustration
at being hamstrung and dependent upon the medical profession
for assistance should he wish to die. If he had been a doctor,
he would know how to obtain a peaceful death when he felt the
time was right. All people, he argued, should have the right
to die at a time of their choosing. A pill would confer this
power.
Thus the concept of an accessible and reliable pill was born,
a concept highly relevant to older people and the terminally
ill. And just as the first "pill" - the contraceptive
pill - broke new ground for women's reproductive rights in the
1960s, so I believe the Peaceful Pill will revolutionise the
quality of life of other groups within our community.
When I visited Drion at his home in Leyden in late 2003, he
talked about the idea and wished our group Exit International
well in our efforts to realise his vision. He died in April
2004.
The idea of a Peaceful Pill - that is, a substance or liquid
that when taken orally results in a reliable and peaceful death
- is not new. Indeed, in Athenian times, the herb hemlock was
the drug of choice for suicide and it was taken in liquid form
- most famously by Socrates.
More recently, cyanide has been used to make suicide pills.
However anecdotal reports tell of cyanide taking up to 15 minutes
to work, all the while causing an agonising death. Importantly,
though, sleep does not precede the death, and it is death while
asleep that most people seek.
The barbiturate Nembutal is the drug that comes closest to
what Exit seeks to provide in a Peaceful Pill, although its
manufacturability and limited availability put it beyond the
reach of most elderly or seriously ill Australians. Many a famous
person died using barbiturates, including Marilyn Monroe, Judy
Garland and Jimi Hendrix.
But over the past 30 years, barbiturate sleeping tablets have
been slowly taken off the market in Australia. In 1998 there
were only two left, and in that year Nembutal was suddenly withdrawn.
It was the drug I used in the Deliverance Machine in Darwin
during the short life of the Rights of the Terminally Ill Act.
In countries where voluntary euthanasia is legal and any drug
can be used, Nembutal remains the drug of choice. But in Australia,
it is only available from veterinarians, who use it as an anaesthetic
agent during surgery, and as a drug to euthanase pets.
The Australian Veterinary Board has recently become aware of
people's interest in this drug, partly because of my speaking
in the media about it.
Some time ago, I was making a clinic visit to the bedside of
Harry, a dying patient. With his wife at his side, he asked
me which drugs would allow him to peacefully end his life. As
I normally respond when asked these questions, I started by
explaining that the "best" drug was Nembutal, but
that this was only available in Australia from a vet.
Later, after Harry had died of his disease, I heard that his
wife did indeed obtain a 100mL bottle of liquid Nembutal. Despite
this, Harry never used it. She told me it sat in his bedroom
over the last weeks of his life and that he drew immense comfort
from knowing it was there.
I know of cases where dying people have paid up to $5000 for
a single
100mL bottle of Nembutal that vets buy for less than $100. Its
availability in countries like Mexico and Indonesia has been
investigated by Exit, and we have asked our members travelling
to these and other countries to visit veterinary supply shops
in order to test how easy it is to obtain. It is certainly no
crime to ask for the product, and the information when compiled
is of great assistance to our members.
I also often get asked about obtaining Nembutal via the internet.
The only person to obtain Nembutal this way was Nancy Crick,
a 69-year-old Gold Coast woman who took her own life in May
2002. When taken as a drink and followed by alcohol, this clear,
odourless liquid with a bitter taste provides a fast, peaceful
and pain-free death.
Exit's aim in developing a Peaceful Pill is clear: to replicate
the painless, easeful death provided by a drug like Nembutal.
We now have two very different projects under way, both aiming
to create the means by which Exit members can provide for themselves
the option of a peaceful death, at a time of their choosing.
The first of these projects concerns the creation of a home-made
version using ingredients that have such widespread use in society
that they will never be restricted. Nicotine, alcohol and paracetamol
are just a few examples.
To date, this project has led to a pill being developed from
nicotine and chlorinated alcohol, but with testing so problematic,
laboratory trials are set to continue into the foreseeable future.
The second project - the Peanut project - is a more ambitious
undertaking that is expected to have its first phase completed
by mid-year. It involves a group of Exit members coming together
to manufacture their own professional-strength Nembutal-like
barbiturate. The input of former scientists, laboratory technicians
and academics has been vital.
Compared to dying with a plastic bag on your head or with the
tubes fastened around your face, a Peaceful Pill has clear advantages.
Just over 40 per cent of Exit members are worried that the
pill might fall into the wrong hands (perhaps those of a mentally
ill person or a troubled teen). Indeed, there are risks associated
with the Peaceful Pill, but does that mean we shouldn't proceed?
I think not.
I was once asked by a right-wing American magazine: should
any restrictions be placed on euthanasia generally? If I am
depressed, do I qualify? If an elderly woman's husband dies
and she says she no longer has anything to live for, would you
help her kill herself? Who qualifies? Who decides if a life
is worth living?
My response was that I do not believe that telling people they
have a right to life while denying them the means, manner or
information necessary for them to give this life away has any
ethical consistency.
So all people qualify, not just those with the training, knowledge
or resources to find out how to "give away" their
life. This includes the depressed, the elderly bereaved, [and]
the troubled teen. If we are to remain consistent and we believe
that the individual has the right to dispose of their life,
we should not erect artificial barriers in the way of sub-groups
who don't meet our criteria.
However, I choose to restrict myself to that group identified
in the overturned legislation. I involve myself with terminally
ill adults who are articulate, lucid and not suffering from
clinically treatable depression.
The law means there are significant risks for Exit should we
act on it. This is why if people wish to make a Peaceful Pill,
they must do it by themselves, for themselves.
Most voluntary euthanasia groups have now chosen to focus solely
upon legislative reform. In contrast, Exit remains sceptical
about the legislative process or the goals it purports to be
able to deliver, particularly in the current political climate.
It seems clear that the Peaceful Pill has a big future, and
not only for the seriously ill but for all rational, elderly
members of our community. Nursing homes, for example, would
only be inhabited by people who were happy about still being
alive because they would know that they could leave if things
got too undignified.
And what about families, for whom the horrific, unnecessarily
slow and often undignified deaths of their loved ones leave
in their wake lasting trauma? And then there are the terminally
ill. These people could maintain their sense of self and dignity
right up to the end if a Peaceful Pill was on hand.
The medical profession could finally acknowledge the duplicity
of slow euthanasia. Doctors could openly engage with their patients
as equals, and patients would have real choice, real options,
and such a person's relationship with their doctor would no
longer be fearful or dependent.
We could live in a world in which those who want to die can
die, and those who want to live are given every chance, a world
where Drion's "universal access" model prevails, a
better world than the one we've got now.
(Penguin, $32.95) This book is published in Australia
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