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The birth of assisted euthanasia

by Sean Ruck, Contributing Editor | September 17, 2017
From the September 2017 issue of HealthCare Business News magazine

As long as there are people alive, it’s nearly a guarantee that there will be debates about life and death.

The questions include the death penalty, pro-choice and pro-life and another issue that doesn’t get as much media attention, but may in the future as our population ages, assisted suicide.

For some time in the U.S., it was a big news story. It had a main character in Dr. Jack Kevorkian, which helped to push the story. To some, Kevorkian was a villain, to others a hero. But while Kevorkian performed his first public assisted suicide at the end of 1990, the legality of the act was gray. It’s true that at the time, Michigan, the state where the assisted suicide took place, had no laws against it. But it also didn’t have laws for it, so it kept the doors open to legal issues. And, in fact, the state would go on to revoke Kevorkian’s medical license the following year.

Although Kevorkian had the spotlight and the microphone in regard to assisted suicide, the first legally assisted suicide would actually take place six years after Kevorkian’s first public act and on the other side of the globe, in Australia.

Bob Dent was terminally ill with prostate cancer. Over the course of five years, he had undergone a number of surgeries by the time the Rights of the Terminally Ill Act was brought into law by the Northern Territory of Australia in May 1995. At that point, Dent was incontinent and impotent, had a recurring hernia and a partially collapsed lung. He was bedridden and in constant pain. He saw the law as an opportunity to end his life on his own terms.

The Rights of the Terminally Ill Act, according to proponents, had safeguards to ensure it wouldn’t be abused. Through it, patients could be euthanized if they made that decision and they obtained signatures from a psychiatrist, a medical professional specializing in the patient’s illness and a palliative care specialist. Dent was first in line.

He enlisted the medical assistance of Dr. Philip Nitschke. Unlike Kevorkian, Nitschke wasn’t an outspoken advocate for physician-assisted suicide. In fact, he only started to argue the case after learning that the Australian Medical Association was pushing hard against the legislation introduced by the chief minister of the Northern Territory, Marshall Perron.

Nitschke said during an interview after Dent’s death that he “thought, what an insufferably arrogant, paternalistic attitude.”

As a result, he stepped in to be one of the doctors that would help end a life rather than save or extend it.

On Sept. 22, 1996, Nitschke met with Bob and Judy Dent. The three shared lunch and small talk before Dent retired to the veranda and rested on a lounge while Nitschke made the preparations. He inserted a needle into Dent’s arm, connected the cannula and machine and moved back to let Dent’s wife step forward to be with him for his final moments.

Nitschke asked Dent once more if he was sure he wanted to take the final step. Dent reached for the laptop computer that controlled the apparatus. He clicked “yes” to the three questions that were asked on-screen and then fell asleep as the drugs took effect.

Nitschke assisted three other people with euthanasia before the law was overturned 11 months after it was introduced. Today, although suicide is legal in Australia, assisted suicide is not, and if convicted, accomplices could be jailed for life. Even after the law was struck down, Nitschke was involved with other assisted suicides and was eventually suspended by the Australian Medical Association. He fought the suspension and won, but after the AMA put conditions on his continued licensing that included barring him from talking to people about assisted suicide, Nitschke publicly burned his license and moved to Holland. He is still advocating today.

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