Australia Reconsiders Euthanasia Law

February 2, 1997

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• By SETH MYDANS

   

  DARWIN, Australia -- The last meal of sandwiches and beer seems to have been more agonizing for Dr. Philip Nitschke than for the cancer-ridden patient whose life he was about to take.

  "I just about choked on my ham sandwich," the doctor said. "I was very, very anxious to the point where I was sweating. He spent a lot of time trying to calm me down, and I thought: 'Great. You spend your last meal trying to pacify the doctor."'

  Then the 66-year-old patient, Robert Dent, said, "You've got a job to do; get on with it." And Nitschke inserted into Dent's arm an intravenous needle connected to the doctor's battered gray laptop computer.

  Without another word, the doctor recalled, Dent punched in a series of commands, a lethal dose of barbiturates began flowing into his veins and moments later he was dead -- the first person to die under a landmark law allowing doctors to kill patients who want to end their lives.

  Dent's death last Sept. 22 and two more that followed in January are at the center of an emotional debate in Australia as Parliament appears bent on overturning the world's only voluntary euthanasia statute, which took effect last summer here in Australia's Northern Territory.

  In confronting the issue, Australia has become a testing ground for other countries, including the United States, that are considering the tangled legal and moral issues raised by rapid medical advances that are prolonging both life and the process of dying.

  In January, the U.S. Supreme Court heard arguments on whether the Constitution gives terminally ill people a right to doctor-assisted suicide -- a slight step short of the death administered by doctors that is permitted here. This summer the court is expected to rule on whether to reinstate laws that were overturned in New York and Washington state banning doctor-assisted suicide.

  "In 20 years' time we will be able to keep virtually everyone alive indefinitely," said the author of the Northern Territory's law, Marshall Perron, at a Parliamentary hearing here in late January. "More and more, we are going to die when someone makes the decision that we are going to die."

  Six senators had flown to Darwin to hear testimony about the law, and their generally hostile comments supported a growing sense that the national Parliament was likely to overturn it later this year.

  The law has been vigorously opposed by religious groups and the country's conservative medical establishment. Aboriginal groups are also opposed, both on religious grounds and because of fears that have taken hold in their communities that their lives could be taken when they seek medical care.

  The issue has aroused passions around the nation, and Parliament has already received 14,000 written submissions from the public.

  At an overcrowded public hearing the night before Perron, the former chief minister of the Northern Territory, addressed the senators, 51 people rose to speak, some sharing painful personal stories, some invoking religious principles, one man leading the audience in a chant of the word "choice."

  "This law is not about the right to die," cried Terry Secker, to applause and catcalls. "We all have the right to die. This law is about the right to kill!"

  Rick Bawden, a photographer, countered: "Can someone tell me what's ethical about telling someone who wants to die: 'Nope. Sorry, mate'? This is torture!"

  Charles Kerms disagreed, saying he was here at the urging of his wife, who had been bedridden and nearly blind for 15 years. "She told me: 'Go there tonight and tell them this: We are not animals. We are not an "it." Tell them we are made in the image and likeness of God."'

   

   

   

  The voluntary euthanasia law, which was enacted in 1995 and took effect last July, is the first anywhere that explicitly allows doctors to take their patients' lives. Though Nitschke rigged his computer to allow his patients to initiate their own deaths, he could have legally administered the injections himself.

  In the Netherlands, with some of the most permissive laws on the subject, euthanasia remains illegal. But guidelines passed in 1993 allow doctors to help patients take their own lives under certain circumstances.

  Switzerland also allows doctor-assisted suicide in carefully controlled situations.

  Under the Northern Territory's Rights of the Terminally Ill Act, a patient must be over 18 and be mentally and physically competent to request his own death. The request must be supported by three doctors, including a specialist who confirms that the patient is terminally ill and a psychiatrist who certifies that he is not suffering from treatable depression. Once the paperwork is complete, a nine-day "cooling-off period" is required before the death can proceed.

  The law applies to nonresidents as well, and opponents have expressed concern that the Northern Territory, a remote and thinly populated jurisdiction in north-central Australia, could become the world's suicide capital.

  But the one nonresident who did take advantage of the law, Janet Mills, 52, faced weeks of resistance and was forced to make a public plea for help before a cancer specialist would support her request to die. There are only a handful of specialists in the territory, and Nitschke said most were reluctant to participate. She used Nitschke's computer to take her life on Jan. 2.

  With the deaths of Dent, Mrs. Mills and an anonymous 69-year-old male cancer patient who died on Jan. 22, Nitschke, 49, has found himself something of an outcast among his peers. Many people have been shocked by what some call his "computer-driven death machine," a 3-year-old Toshiba laptop on which he also surfs the Internet and reads his E-mail. He connects the computer to a pump-driven syringe filled with three barbiturates, which he carries in an old gray suitcase.

  Last September, after Dent, a carpenter, had eaten his ham sandwich, the doctor said he switched on his computer, which makes a loud buzzing noise, and the first black-and-white screen flickered on.

  "Are you aware that if you go ahead to the last screen and press the 'yes' button, you will be given a lethal dose of medicine and die?" the computer asked in large, bold letters, displaying the options "Yes" and "No."

  Dent pressed the key for "yes" and moved to the second screen, which reads, "Are you certain you understand that if you proceed and press the 'yes' button on the next screen, you will die?"

  Dent hit the key again and faced the final message: "In 15 seconds you will be given a lethal injection." He pressed the key for "Yes" a final time, waited as the computer continued to buzz, and in 15 seconds a rhythmic pumping sound emerged from the suitcase.

  Moments later, the screen went black except for one word: "Exit."

  Dent, who had been suffering from prostate cancer for five years in what he called "a roller coaster of pain," left an open letter when he died.

  It said: "If I were to keep a pet animal in the same condition I am in, I would be prosecuted. If you disagree with voluntary euthanasia, then don't use it, but don't deny the right to me to use it."

  Although Nitschke has become Australia's most visible advocate for euthanasia and is an admirer of Jack Kevorkian, the Michigan pathologist who has helped dozens of people commit suicide, Nitschke said his work had worn him out emotionally.

  "You can't help but feel like an executioner," he said. "You can't get around that. You walk in that room, and you know that there will be one less person when you walk out."

  The procedure has been all the more stressful because, before they could proceed with a death, he and his patients have had to become allies in a highly publicized struggle to persuade two other doctors to support them.

  "You get to know people," he said. "And then you just end up one day killing them. You may have good intentions, but it's very bizarre."