Peaceful Pill Blog
January 31, 2021
Vale – Kevin Andrews Loses Preselection
International readers may well ask who is Kevin Andrews?
In a nutshell, he’s the guy whose private member’s bill in the Australian Parliament (The Euthanasia Laws Act) led to the overturning of the world’s first voluntary euthanasia law – the Rights of the Terminally Ill Act (NT) (ROTI) in 1996.
A Catholic extremist, (and well known for his traditional marriage counselling prowess) Andrews once boasted that he had set the euthanasia movement back 20 years. And he was right.
Why do we highlight this now?
This week, Kevin lost the vote (pre-selection) in the Australian Liberal Party (Australia’s right wing political party) to continue as their candidate for the Melbourne seat of Menzies.
Kevin will never again represent the electorate of Menzies in the Australian national Parliament.
Twice I campaigned as an Independent candidate in Menzies against Kevin Andrews (See archive photos below!).
In 1997, I forced him to preferences. This meant I came the closest of any candidate during his tenure to beating him. Sadly, Menzies is a safe Liberal seat and so Kevin prevailed.
Until now …
Below is an extract from my book – Killing Me Softly: Voluntary Euthanasia & the Road to the Peaceful Pill – that puts that man and that time in perspective.
How could this happen?
In my mind, strategic and persistent lobbying of politicians could have prevented the passage of the Kevin Andrews Private member’s bill.
I was furious that the state voluntary euthanasia societies were not prepared to do more to save the ROTI Act.
Canberra (Federal Parliament) was able to override the NT legislation through use of Section 122 of our Constitution which grants the Commonwealth the power to make laws for the government of any territory of Australia.
While state laws are preserved, the Northern Territory, Norfolk Island and the ACT are subject to this special power – a power which rides rough-shod over proper, regional democratic processes.
But this is only half the story.
The other half concerns a wide-reaching network of people, many from within the Lyons Forum (the secretive organisation of the far-Right of the Liberal Party) and Catholic Church-based propagandists.
With ringleaders headed by Kevin Andrews but including former Young Labor president Tony Burke – and now member of the shadow cabinet –and Sydney businessman Jim Dominguez, the ‘Euthanasia No’ campaign was well-funded and effective.
In the words of award-winning journalist Michael Gordon, the No campaign was a ‘story of a network [where] all the principals are Catholics – its influential connections, its single-mindedness and the tactics it employed’.
White ants in the media
A second group that set out to undermine the legislation was the national media, most particularly The Australian newspaper in Sydney. As a prominent member of the ‘Euthanasia No’ campaign, the then Murdoch-hack & editor-in-chief, Paul Kelly, openly abused his position at the paper to promote ‘Euthanasia No’, ensuring his personal opposition to voluntary euthanasia was effective in the process.
Kelly’s complicity in the campaign was exposed to me by The Australian’s then Darwin correspondent, Maria Ceresa.
While her Fairfax counterpart, journalist Gay Alcorn, filed stories without bias, Ceresa was increasingly thwarted by the paper’s hierarchy in her coverage of the issues surrounding the ROTI law.
Ceresa would later tell me that unless the story was highly critical of the legislation, the paper would not run it. She felt herself professionally compromised as a result.
White ants in the right-to-die movement
To my dismay, during 1996 I discovered that the right-to-die movement itself was unwittingly helping to undermine the legislation. I knew something was not right as I travelled from state to state during 1996, trying to involve the VE societies, and trying to get them to mount a coordinated campaign to save the ROTI Act.
But the response I received was patchy, and although I managed to get representatives from Queensland, South Australia and the ACT together for a strategy meeting in Canberra, there was little willingness to pool resources and mount a national campaign.
As for the Victorian society, they did not even attend the meeting and argued that it was unwilling to put money into a project that would not directly benefit that State. Later I met with the president, Dr Rodney Syme, and the then executive officer, Kay Koetsier, whereupon they expanded on this view.
Syme explained that while the society was prepared to pay for survey work that could benefit Victoria, there would be no involvement in a national campaign to lobby federal politicians. Koetsier went so far as to claim that the passage of the Andrews Bill could even bode well for Victoria.
When I asked Koetsier to elaborate on this extraordinary claim she said that if the Senate voted in favour of the Andrews Bill, there would be a national outcry.
Then, the Premier of Victoria, Jeff Kennett, would take it upon himself to ‘do the right thing’ for the people of that State, and pass right-to-die legislation. History tells us otherwise. I found Kay’s comments to show a profound lack of judgement.
I told her I didn’t agree and the conversation moved on.
In retrospect, it was little wonder the ‘Euthanasia Yes’ campaign was defeated. Not only was the Commonwealth–Territory power not on our side but the media, the Church and a whole network of powerful and wealthy people pulled out all the stops to defeat the landmark legislation.
The parliamentary word
In an unprecedented occurrence, when the Kevin Andrews Bill was finally debated in the Senate it went on for the best part of four days. The speeches heard in both houses of parliament were some of the most emotional ever made by Australian politicians. While some MPs spoke about the rights of the individual, others views were fueled by the dogma of the Catholic Church. Some talked critically of State/Territory versus Commonwealth powers.
The speech of Labor frontbencher (now Labor leader) Anthony Albanese is of note for its eloquence and passion: ‘This debate is hard – real hard,’ Albanese said. ‘It is hard because it is about death.’ He went on:
Most people are uncomfortable talking about dying … [Yet] this debate, as hard as it may be, is important. The outcome of this debate will reflect on our maturity both as a parliament and as a nation for it will determine the manner in which we seek to control each other’s lives.
I oppose this [Andrews] bill because I support human dignity. I oppose this bill because I support freedom of choice. I oppose this bill because I support civil liberties. I oppose this bill because my Christian upbringing taught me that compassion is important. I oppose this bill because modern medical practice should be open and accountable, not covert and dishonest…
I oppose this bill because I oppose the moral posturing of the Lyons Forum. I oppose the hypocrisy of those who say, ‘This debate is so important’ and then vote to debate it upstairs in sideshow alley.
Most importantly, I oppose this bill for one critical reason, and that is this. We have all accepted that this parliamentary debate should be a matter for our conscience.
How arrogant to then suggest that the ability to exercise conscience should be taken from a seriously ill patient who wants to die. There is nothing moral about our exercising a free conscience vote as members of parliament and then voting to deny to others the right to exercise their conscience.
What possible right do Kevin Andrews, Leo McLeay, Lindsay Tanner or Anthony Albanese have to have exercised Bob Dent’s conscience for him? It was his decision and he had a right to do that.
Of those who focused on territory rights, it was the Territory’s own Senator Bob Collins who led the way. Although a hostile opponent of the ROTI law, Collins was angry at the vilification of both the Territory and its politicians by Federal Parliamentarians. He was especially critical of Kevin Andrews and Senator Eric Abetz from Tasmania.
He was angry at Andrews for his audacity to think that ‘Territorians have no rights, only obligations’. Collins was also scathing of Abetz when the latter had tried to argue that ‘the Northern Territory parliament exists only by the grace and favour of the Commonwealth parliament. What the Commonwealth parliament gives, it can also take away’.
‘This’, said Collins, ‘from a senator from a state with about twice the population of the Northern Territory’s, and five times its representation in the House of Representatives and six times its representation here in the Senate’.
Mark Latham also supported both points made by Collins, but is best remembered for the following:
The euthanasia debate … should not be about forcing terminally ill people to judge life itself through the prism of someone else’s moral code. The only way religious questions have ever been successfully dealt with in public policy is by fostering choice.
Terminally ill citizens deserve nothing less than liberty in determining the manner by which their lives might end.
Other politicians focused more on their own moment in history.
Citing the eighteenth-century libertarian Edmund Burke in some detail, Barry Jones followed Burke’s lead, stating that he as ‘your representative’, ‘owes you, not his industry only, but his judgment; and he betrays instead of serving you if he sacrifices it to your opinion’. Jones’s mistake – and that of other politicians who drew on Burke – was to believe that it was appropriate for politicians to dismiss the ‘opinion’ of their electorates in favour of their own prejudices.
Sure, the political paternalism of Burke might have suited the uneducated, illiterate electorate of Bristol more than 200 years ago. But it is nothing short of arrogant to suggest that politicians like Barry Jones should do our thinking for us.
If Burke must be treated as the patron saint of politicians, then those who quote him should reacquaint themselves with the letterhead of the Whistle Blowers’ Society: ‘All that is necessary for the triumph of evil is that good men do nothing’.
Letters to the editor in the Sydney Morning Herald echoed my own feelings at what had just happened at the hands of the politicians:
I don’t understand why these evangelists of their own belief systems have the right to take away another individual’s right to end his or her own suffering.
This is the worst kind of politicking, far worse than acting out at Question Time, making errors with expenses or jetting around on fact-finding missions. I don’t care what ‘God’ a politician chooses to follow, but when his belief affects others I consider he has overstepped his already poor standing in the community.
My heart goes out to those who are suffering and those wanting to help them within the law.
The phoenix that rose to become Exit International
As the fog lifted in the weeks following the success of the Andrews Bill, it became clear that while the ROTI Act was no more, the need for people to have access, if not to voluntary euthanasia, then to information about end-of-life options remained. Sick people still wanted to die. And so my focus changed. Political lobbying was over.
The previous twelve months had been as intense as they had been public and they had taken their toll on me. Yet I found that my work was just beginning.
I established the Voluntary Euthanasia Research Foundation (VERF) for people wanting to find out more and began a workshop and clinic program for people wanting to find out more that has since spread to all Australian capital cities and more recently to New Zealand.
One of the other challenges I took on in 1998 was to stand against Kevin Andrews in the federal election. Putting my money where my mouth was, I moved to Melbourne to stand in Andrews’ own electorate of Menzies, in Melbourne’s eastern suburbs.
During the campaign I worked closely with the Victoria Voluntary Euthanasia Society. Distinct from the poor effort they had made defending the NT legislation in Federal Parliament, they put their total support behind my challenge, and it gave me some insight as to what might have been possible when we were trying to defend the ROTI Act. If only.
Over $120 000 in donations came in, an amount that stood then as one of the highest records for campaign funds ever raised by an independent candidate. On election day we secured nearly 10 per cent of the primary vote.
While I’m not sure how worried Kevin Andrews was on that day, we were pleased that the Liberal seat of Menzies was forced to count preferences for the first time. This seemed suitable payback for the misery that his bill had caused, and this sentiment reminded me of another letter I had seen in the newspaper back in March 1997:
May I wish Mr Kevin Andrews a long and excruciatingly painful life.
With the 1998 election out of the way, my attention turned to the world stage and I flew to Zurich to attend the Conference of the World Federation of Right-to-Die Organisations.
There I spoke at length on the concept first put forward by Huib Drion of the Drion Pill.
Building on the conceptual work of Drion, I presented my own early thoughts on what the development of a ‘Peaceful Pill’ project might involve.
Given the unlikelihood of another VE law, I was already aware that new strategies were needed.
VERF, the foundation I established, was renamed Exit … the rest as they say is history.
Philip Nitschke, Amsterdam 31 January 2021
December 8, 2020
Mental Illness & the Good Death
This blog entry has been prompted by the recent wave of law reform occurring in Australia and its neighbour, New Zealand.
From a rocky start some 25 years ago when the Northern Territory (one of Australia’s 3 territories vis a vis states) passed the Rights of the Terminally Ill Act (the law lasted only 9 months before it was overturned by the Federal Australian government).
Fast forward to 2021 when Victoria and West Australia have passed assisted suicide/ dying laws, and the cogs of the legislative wheel are now turning in Tasmania and Queensland.
Every place in Australia (and New Zealand for that matter) that has passed or is contemplating the introduction of end of life choices laws, is excluding people with a mental health diagnosis.
In the area of mental illness and assistance to die, Australia and New Zealand are following the lead of countries like the US and Canada in excluding mental illness as a qualifying criteria.
Australia is not following the lead of countries such as the Netherlands, Belgium and Luxembourg where euthanasia is not only available to children, but to the mentally ill.
While Swiss law mandates ‘mental capacity’ before a person can be helped to die, that country has also, wisely, decided against a conflation of mental illness with a loss of capacity.
For this they are to be commended.
As a position statement, Exit International fully supports the right of a mentally ill adult to a) take their own life and b) request assistance to take their own life, as long as they have the mental capacity to make an informed choice and to understand the consequences of their actions.
While mental capacity is usually determined by a psychiatric assessment (as is the process at Pegasos in Switzerland), Exit is currently exploring AI (artificial intelligence) possibilities in this regard.
This exploration of AI is intended to contribute to the demedicalisation of death: to finally, and once and for all, remove control over the decision to die from the medical profession.
It is indefensible, and ignorant, for a law on end of life rights to automatically exclude a person with depression, dementia or other mental illness from being able to request assistance to die. Or to be able to take their own life themselves.
This is the medical model of ‘mental capacity’ determination run wild.
It raises the question that never goes away. What right should the medical profession have over a person’s right to die?
The more progressive scholarly literature shows that mental capacity cannot, and should not, be determined (or predicted) solely on the basis of a mental illness diagnosis.
Nor should a civilised society wash its hands of those who are mentally ill: people who may present with a long-held, considered wish to die.
Exit welcomes people who have mental illness to subscribe to the Peaceful Pill eHandbook.
We do what we can to be egalitarian in access.
What we request is that subscribers show they have the mental capacity to make informed decisions. One’s diagnosis is much less important.
Exit’s approach mirrors that of western legal systems where mental capacity is assumed, unless there is evidence to the contrary.
Adam Maier-Clayton (27 years) made contact with Exit and had several conversations with Philip Nitschke about the end of life options available to him.
Adam then used the Peaceful Pill eHandbook to obtain end of life drugs.
He did this with the support of his parents who did not want him to live a life of suffering.
Adam had multiple mental health diagnoses including severe anxiety, obsessive-compulsive disorder, and dissociative disorder. Did he have mental capacity? Without doubt!
What upset Adam’s parents (and Philip Nitschke) was that Adam died alone in a strange motel room.
Adam wanted to shield his parents, Margaret and Graham, from any accusation that they assisted him.
Adam Clayton was a young, intellectual man with a deeply considered (and considerate) outlook on the world.
Vice told Adam’s story in their 2019 feature documentary, Time to Die.
Adam Maier-Clayton remains an inspiration to Exit in our work towards ensuring that ‘a good death is everybody’s right’: not only those who are terminally ill with < 6 months to live as Australia’s new laws demand!
November 8, 2020
Dying in Switzerland during COVID-19
This week’s news has concerned an anonymous 45 year old British woman (Ms Anon) who went public with her plight to die.
According to the media reports, her story went like this.
She had gone from working in a senior position in the NHS (National Health Service). But then got the diagnosis so many women dread: breast cancer.
With a terminal diagnosis, Ms Anon, was opting for Switzerland. A trip to Zurich, to Dignitas to be specific.
The media reports made 3-4 main points.
We applied the Exit Fact Checker to each of them to see where the truth lies!
- Right to die laws in the UK are archaic! TRUE
- If she was going to go to Switzerland she had to go before lockdown POSSIBLY TRUE THEN BUT NOT TRUE NOW
- She got a personal exemption for travel from the Swiss Government FALSE
- She had to leave family behind FALSE
Let’s take each in turn.
UK Right to Die Laws are Archaic
The most recent attempts to change the law in the UK, concern the Assisted Dying Bills of Labor Lord Charlie Falconer (2014) and then MP for Wolverhampton South West, Rob Marris (2015).
The laws proposed were strict medical models.
Terminally ill, no dementia (or other mental illness), approved by 2 doctors. No Ifs & no buts.
Neither Bills produced a change in the law in the UK.
Leaving the UK in Lockdown for a VAD in Switzerland
Until the UK Health Secretary Matt Hancock clarified the status of travel for a VAD during the British lockdown, this point was perhaps not clear.
It is now obvious that a one-way trip to Switzerland for an assisted suicide constitutes a ‘reasonable excuse’ for leaving home.
Personal Exemptions to Enter Switzerland
During the pandemic, groups such as Pegasos Swiss Association have been operating quietly and consistently, working with the Swiss Authorities to allow clients into the country for the purpose of a Voluntary Assisted Death.
Pegasos has achieved this streamlined operation via their quiet professionalism, and in the context of their excellent relations with the Swiss Government.
Pegasos has never needed to enter into their own fanfare. They have no need for sensational headlines, believing instead that quietly-but-surely is the best way to conduct their VAD service at this time of great need.
So-called ‘Personal Exemptions’ have never been required if the person coming to Switzerland is a member of a well-administered, professional organisation such as Pegasos Swiss Association.
Leaving Family Behind
Throughout the COVID-19 pandemic, Pegasos Swiss Association has continued to welcome the family and loved ones of the person receiving the VAD at their clinic outside of Basel.
No one has needed to leave their family behind, just because of COVID-19
The Swiss Government recognises that a person coming to their country for a VAD should be supported by those they love. This is the only compassionate thing to do.
It is nothing short of misleading to suggest that a person must have a VAD alone in Switzerland. The experience of Pegasos shows that this is simply not the case.
This blog post has been written to provide correct, factual reporting on the current state of play of dying in Switzerland.
While it is to be expected that the media can get important points wrong, the type of scare-mongering put out by Dying with Dignity UK, a lobby group who should know better, is both disappointing and destructive.
Anyone desperate enough so as to be interested in going to Switzerland to die, should not be used as a political pawn in a group’s advocacy campaigning.
There is more to the promotion of the right to die issue than the tabloid headline. There is the ethical and moral obligation to push and report the facts as they stand. Not as some shameful, worse case scenario, peddled only to an organisation’s personal brand profile.
People’s lives (and deaths) are at stake.
November 1, 2020
NZ Votes Yes to Voluntary Euthanasia
On Saturday 17 October 2020, New Zealand held its most recent federal election.
Coupled with the election were 2 referenda.
One on euthanasia, the other on cannabis.
In counting to date, around 65% of voters voted in favour of legalising assisted suicide/ assisted dying for the terminally ill. The final result will not be known until 6 November.
This is perhaps, in part, the legacy of NZ lawyer, Lucretia Seales, who died of a brain tumour in 2015.
The new law will not take effect until 12 months after the result is know (so that is 6 November 20201 – if they world does not end first).
This is a bit of a major step for a country whose Chief Censor (yes such a post exists in New Zealand), 12 years ago, banned and then approved (with heavy redactions) an early edition of The Peaceful Pill Handbook. Censorship is alive and well in this country.
Voting ‘yes’ is also a major step for a country that continues to harbor such conservative anti-choice groups such as the Society for the Protection of Community Standards.
It is a major leap forward for a country who, in the 1950s, eagerly classified one of its most famous writers, Janet Frame, as an antipodean madwoman with schizophrenia, while her diagnostic conclusion in the UK was that she was ‘just different’; a shy woman who preferred to be alone.
And in case readers were at risk of forgetting, this is the country where in 2016 Police set up an unlawful roadblock, known as Operation Painter, not far from Suzy Austen’s potluck Sunday lunch to trick the Exit Members who attended into handing over their name and addresses; so as they could be put under police surveillance and later visited and compelled to hand over any end of life drugs they may have illegally acquired.
What is it that New Zealanders have voted for?
As with the Australian state of Victoria, when voluntary euthanasia/ assisted suicide/ assisted dying becomes the law in NZ, it will be situated within the medical model.
Those assisting must be medical professionals.
Those receiving the assistance must be terminally ill with < 6 months to live.
People of advanced old age are excluded from eligibility as are those with a disability (eg. quadriplegia) or a mental illness, such as dementia.
The End of Life Choice Act
- be aged 18 years or over
- be a citizen or permanent resident of New Zealand
- suffer from a terminal illness that is likely to end their life within 6 months
- have significant and ongoing decline in physical capability
- experience unbearable suffering that cannot be eased
- be able to make an informed decision about assisted dying.
A treating doctor may also NOT suggest voluntary euthanasia as an option.
A request for voluntary euthanasia may NOT be included in an advance directive.
Interestingly, the Act DOES provide for the administration of a lethal injection, instigated by either the person or the medical professional.
Medical Profession Oversight
As with all medical model end of life laws, doctors will play a central role in the End of Life Choice Act.
In this regard, if a doctor decides that the person requesting assisted dying is eligible, they must seek a second opinion from an independent doctor.
The independent doctor must also agree that the person meets all the criteria, which includes being competent to make an informed decision about assisted dying.
If either doctor is unsure of the person’s ability to make an informed decision, a third opinion from a psychiatrist is required.
1. Ingestion, triggered by the person.
2. Intravenous delivery, triggered by the person.
3. Ingestion through a tube, triggered by the doctor or a nurse practitioner.
4. Injection, administered by the doctor or a nurse practitioner.
Oversight will be via the ‘Support and Consultation for End of Life in New Zealand (SCENZ) Group’ and an End of Life Review Committee.
This SCENZ Group will ‘make and maintain a list of doctors who are willing to act as replacement and/or independent doctors’.
A Summary of the End of Life Choice Act
As with all medical model legislation, there are considerable hurdles that must be completed before one is able to use the law.
This type of regime of so-called safeguards makes the society that has voted in the law feel much more comfortable with their decision.
However, it harks back to the question raised by Bob Dent in Darwin in 1996 when he became the first person in the world to receive a legal, lethal voluntary injection under the Rights of the Terminally Ill Act (NT).
Bob questioned the fact that as a dying man he was forced to undergo so much final testing, just to be able to die in peace. He always maintained that had he had the drugs at home in the cupboard he would have simply gone quietly to the cupboard and taken them. He did think it fair or reasonable to have been seemingly persecuted by the burden of proof.
And then there are the Issues of Old Age & Awful Diseases that Kill Slowly
A law that expressly excludes people of advanced age, people like 104-year old Australian ecologist Professor David Goodall, who was not sick but was old (enough), are not laws for everyone.
And a law that mandates certain death within 6 months is simply cruel. Such a law would never have served Melbourne firefighter Troy Thornton who had multiple system atrophy (and was becoming slowly but surely completely paralysed, and who chose to die in Switzerland) or New Zealanders like Rachel Rypma who has Huntington’s Disease, one of the most cruel and degrading genetic conditions ever invented.
Indeed, with this exclusion they make themselves laws for the very few.
For Exit this remains a needless restriction. Perhaps the most meaningless restriction; especially given the fact that we are likely to live longer in poorer health than any generation preceding us.
What about the Colonisation of Dying and Death by the Medical Profession?
The one aspect of New Zealand’s End of Life Choice Act must be the central role of the medical profession in the operation of the Act.
Unlike in Switzerland where a person does NOT need to be terminally ill (or even sick), but only needs to have the capacity to understand and initiate the act themselves and the person providing assistance only does so for altruistic reasons, like so many other countries New Zealand has created a framework that inserts a medical professional into an area of human existence which is not intrinsically medical in nature.
As British public health specialist, Dr Lucy Thomas, wrote recently (30 September) in the British Medical Journal:
… giving people access to the means to end their life is not, in itself, a medical procedure, and there is no practical need to involve a medical professional. More fundamentally, it becomes difficult to reduce something as profoundly complex as the desire to end life to a medical problem.
All of us experience suffering in our lives, and at times we all ponder the meaning of our existence in the context of our personal histories, social relationships, and wider circumstances. Many of us have occasions when we question whether our lives are worth living, and some go as far as to consider ending life, either in a moment of desperation or after lengthy, considered deliberation. The underlying existential struggle is not fundamentally different in the presence or absence of illness or disability; nor is it determined by how long or short a remaining life is predicted to be.
In doing so, medical professionals become the gate-keepers of this most private and intimate of all life’s decisions.
And, in being the gate-keepers, they are the wielders and arbiters of power over the lives (and deaths) of others.
Exit congratulates New Zealand on their great leap forward but with these reservations in mind, we wonder how great a leap it truly is, and the perspective of forward and backward can surely only be understood from one’s unique standpoint?