June 13, 2021

Holocaust Survivor Zsuzsi Yardley dies in Switzerland

Exit Life Member – Zsuzsi Yardley – died at Pegasos in Liestal Switzerland on 3 June 2021.

Shortly before her death Zsuzsi wrote:

Dear Friends,

It is more than fifty years ago that I joined a campaigning organisation for the right to make choices at the end of life, called Exit. Organisations change, their names change, my opinions remained, that it is a human right to make such choices while competent to do so.

At present I am a member of Exit International. Such choice has always have to be made with the proviso that no harm should be done to others, where I owe a duty of care, or could give emotional pain.

Once my partner of 34 years, Bill, died five years ago, and then my brother Edgar, there was nobody left close enough to me, whom I would be harming.

In the Autumn of 2019 I decided that my life was good and complete, I had no desire to prolong it and was then actively considering my own end of life choices.

Then I had a stroke, which made things more urgent and at the same time more difficult. It took me some time and a great deal of effort to reach a point where I was again able to act in this matter.

The choices are various do it yourself methods, which may, or may not result in achieving a reliable and peaceful death, or a trip to Switzerland for the same.

It seemed to me the better option to avoid putting friends and/or relations to the trouble to cope with the aftermath and so I applied in January of this year to travel to Switzerland.

It was far from easy to get accepted and to gather the necessary documentation, especially under COVID restrictions.

The time has come to let you know and to send this message with my thanks for your friendship and company over the years.

I wish you all the best for the future,
 
Lots of love,
 
Zsuzsi

Zsuzsi’s many friends replied in kind:

I know you asked for no replies, but you also clearly realised we might have to write for our own needs.
Thank you for telling us what you are doing and why. You are probably one of the most sincere and honest people I have known, so I wish you had reached a different conclusion from your analysis, but I have no doubt at all that you have reached a decision that you believe in and are at peace with.
You leave a huge hole in our lives. You probably underestimate how much we have valued knowing you.
I wholly support your decision but grieve for my loss.

And

I find it hard to reply to your email. I greatly respect your choice to make your own decision how and when to end your life. It is a choice that I agree with, but I know I do not have the courage to make it.
At the same time I feel very sad to be saying good-bye to you. I have so much enjoyed being in the reading group with you and have often wished I could have known you when we were both younger and pursuing our very different careers.

All I feel I can say now is that I hope all goes very easily for you, and I shall always have very fond memories of you.

And this is one of the benefits of being able to plan your time to leave, especially in the absence of serious illness. Everyone has the time to say good-bye. It may be easier to leave without regrets, even if not everyone will understand why you are leaving early.

Zsuzsi’s main reason behind her timing was that she had experienced a stroke and was afraid of another.

As a former Systems Control Engineer (in the oil, water and transportation industries – Zsuzsi supervised sections of the build of the channel tunnel), she was an extremely well-organised woman who analysed the pros and cons of life’s decisions.

As a survivor of the Holocaust, she said it was especially important that she was able to choose her end manner and date. This was the ultimate decision that was hers alone to make.

Zsuzsi spent her final days in Basel drinking prosecco, resting and wandering the neighbourhood close to her hotel.

When the opportunity arose to go a day earlier than planned, she jumped at the opportunity.

After a hearty final breakfast, Philip Nitschke drove with her to Liestal and was there with her until the very end.

Her death was, as all Nembutal deaths are, the most dignified and peaceful imaginable.

Zsuzsi has bequeathed film up to the last minutes of her life to Exit to use as they see fit.

This film will be included in next week’s Swiss Options update to the Peaceful Pill eHandbook.

Zsuzsi’s death does leave a hole in our lives, as remarkable seems a somewhat insufficient description of this person.

Her calmness prior to her death can only be taken as an indication of how absolutely sure she was that she was ready to go.

Just before she turned the infamous white wheel she remarked to a tearful Philip Nitschke that he should not be sad for her, that there was no place she would rather be.

If ever evidence were needed of the ‘good’ that can come as a result of a planned dignified death, then Zsuzsi Yardley is it.

Zsuzsi Yardley, 9 January 1940 – 3 June 2021

Zsuzsi described herself when younger as: a swimmer, skier, rambler ice dancer, general physical activity.

Prior to the covid lockdowns as a: theatre, concert and exhibition exhibition goer.

Prior to her stroke last year as: a gardener.

Since then she said she still exercised with videos and walking daily. ‘I am still driving’ she said.

How to summarise a life? Nigh on impossible.

April 25, 2021

Australia Border Force Seize Peaceful Pill Handbook

It is perhaps ironic that the very week that ABC TV screens Laura’s Choice documentary – a film that features the Peaceful Pill Handbook – that Australia Border Force Seize Peaceful Pill Handbook – copies that have been properly ordered from OS by seriously ill, older Australians.

This is now 2 editions of the book that were ordered by terminlly ill men (in Qld and Victoria) seized in the month of April!!

To readers outside of Australia, the censorship of books is unheard of. Indeed in many places (eg. the EU) it would constitute a breach of one’s human rights.

However despite its urban myth as relaxed, liberal kind of country, Australia has remarkably little in the way of laws that protect some quite basic human rights. While the Australian Constitution protects political expression and religious freedom it is eerily silent on free speech.

The Peaceful Pill Handbook (2007 edition) remains the only Australian book banned in Australia in the past 30+ years.

When the book was initially published, the censor awarded it an 18+ restriction which allowed it to be sold in plain brown wrapping and kept out of sight under the counter (the same as applies for heavy porn). Insert 🙄!

The Attorney General of the day was unhappy with this and so Philip Ruddock banded together with good ol’ Right to Life to challenge the 18+ rating, and succeeded in having the book awarded a RC (restricted classification), as in too dangerous to publish in Australia.

And so the Peaceful Pill Handbook is now an ‘objectionable’ publication in Australia.

The very fact that ‘Australia Border Force Seize Peaceful Pill Handbook’ shows the Australian Government as an absolute anachronism from the 1950s in taking on the role of deciding which books Australian adults can read.

It is the Australian Government – and no one else – that decides what is good for its citizenry!

It is little wonder that the Australian Prime Minister is now under attack for taking a Royal Australian Airforce jet to the Gold Coast in order to address the Australian Christian Churches National Conference this week.

Heritage Church tweeted that at this conference the PM said that Australia needs the church.

So when Australia Border Force seizes copies of the PPH, you don’t need to be a conspiracy theorist to see where the pressure is coming from. Do you?

The history of the banning of the 2007 edition of The Peaceful Pill Handbook can be found at the refusedclassification.com website.

An excellent, insightful, in depth discussion of censorship in Australia can be found in Lachean Humphry’s ‘Three Banned Books’ in the 2017 Summer edition of Overland.

March 28, 2021

Assisted Dying and Organ Donation

At Exit, we are often asked about assisted dying and organ donation. For example, is it possible to donate one’s organs after a suicide or, in the context of an assisted dying law, after the assisted death/ assisted suicide.

In general, the answer has always been no, except in countries such as the Netherlands, Belgium and, more recently, Canada. This is despite widespread organ shortages in almost all western countries.

Indeed, I was especially heartened to receive by mail in Amsterdam last month, notification from the Dutch health authorities informing me that my adopted country now had an opt-out system of organ donation.

This means that should I be hit by the proverbial bus, my organs and tissue will automatically go into the organ collection pool. I can opt out of this new scheme if I want, but I won’t.

There have always been strong public policy reasons as to why a person who is electing to die early/ voluntarily (through a VAD – voluntary assisted death) cannot donate their tissue or organs.

The most obvious of these is the perception that the person may be encouraged to ‘do the right thing’ in order to give their body parts to others. It could be seen that the person is being encouraged to suicide for the greater good.

This standpoint seeminly had enough political traction to be published in the British Medical Journal March 2020. The article by a little known researcher from Belgrade, Dr Zeljka Buturovic, argued that there were no sufficient safeguards that would ‘disentangle MaiD from organ donation decisions’.

Pro-life fanatics such as Wesley J. Smith have long scare-mongered that assisted suicide laws would create untold fortunes for the ‘organ donation industry’. As always with such extremists, the situation is black and white with no room for a nuanced, humanist approach in between. They argue the slippery slope is real; we will soon all be being put down so as organs can be sold on.

Others highly critical of allowing mutual assistance in dying and organ donation such as the outspoken American Catholic doctor, E. Wesley Ely, have suggested that this is a short route towards euthanasia via organ harvesting. That is, people are put down because their organs are removed. Rather than those organs being removed after the person’s ‘good death’ (euthanasia).

The highly politicised field of assisted dying and these sensationalised ‘ethical dilemmas’ (the church is a powerful lobby group) have been enough to scare legislators into excluding the topic of organ donation from many of the new right to die laws that are now sweeping the western world. No where in Australia or the US for example, can a person who is getting lawful help to die, elect to donate their organs.

However, as with so many areas of life, it has been the pragmatic Dutch (and Belgians) who have led the way with devising a path forward where euthanasia recipients can give life to others.

Organ donation has been possible in the Netherlands since 2011, with the first clinical guidelines devised in 2017. More recently, Canada has followed suit. In all countries that allow both practices, the ‘dead donor rule’ applies: meaning that organs are only taken after the euthanasia or assisted death has been completed. So much for the hysterics of the anti-choice lobbyists.

Practical Problems

Of course, organ donation of euthanasia/ assisted dying recipients is no straight forward affair. There are numerous practical issues which make the practice difficult.

For example, most people will need to die in a hospital if their organs are going to be successfully harvested and donated to others. Yet most people want to die at home. Fortunately, modern medicine is coming to the rescue. On 7 March 2021, Canadian Huntington’s disease sufferer, Mike Neill, made the headlines when he was able to donate his lungs. What was so special about Mike’s ‘gift of life’ is that he died at home. The media reported this donation as a ‘world first’.

The donation of a major organ such kidneys, lungs, hearts and livers after euthanasia/ assisted dying stands in stark contrast to tissue donation which can be recovered following home deaths. In this regard, the donation of eyes, heart valves, bone tendons and skin is much more straight forward.

The Benefit of Planning Ahead

Many people who elect for an early death/ assisted suicide have a deeply thought-out sense of the world and their place in it. If we were to characterise Exit Members it would be as older people who know their minds. They tend to be people who have led highly independent, autonomous lives and who are used to making their own decisions and being in control.

One benefit of planning for an assisted death followed by organ donation must be the fact that it can be planned ahead of time, and every detail discussed and thought through.  The relative time of death is always known so the services needed to make the organ donation successful can all be put in place before hand.

Planning ahead for donating one’s organs also removes the person’s family and loved ones from having to make often difficult decisions at a time of extremis. And consent can be withdrawn right up to the last moment, allowing for flexibility in individual decision-making.

Organ Donation in Switzerland

It has long been bemoaned that in the one country in the world where one does not need to be seriously ill in order to get lawful help to die, that organ donation in prohibited. Like most other countries, Switzerland is presumably concerned about the message it would send if recipients of assisted suicide were also allowed to donate their organs.

Would people be pressured into dying, just so their organs could be donated? This seems an ironic question for a country which allows the use of organs of those who die by ‘violent, unassisted suicides’. It seems the principal stumbling blocks for the Swiss lie in practical concerns.

Given that most people who are helped to die in Switzerland die at home or at an assisted suicide clinic, how might the organs get to hospital where they are needed. What about the quality of the organs? And would allowing organ donation act as a disincentive to those travelling to Switzerland for an assisted death if they knew what ‘could’ happen after they are gone.

As a country with a scarcity of organs available for transplant and a historically week culture of organ donation, it seems a hugely wasted opportunity.

Imagine what can be

At Pegasos Swiss Association, one makes the VAD application online. In the course of this application, all sorts of boxes are ticked. What music would you like us to organise for you? Do you wish to have champagne for a final toast? Where should we send your ashes? Who will be accompanying you? And so on it goes.

How sensible, common sense and convenient would it be to add the box, do you wish to donate your tissue and organs once you are gone? Tick for yes.

This would allow Pegasos’ Organ Donation Facilitator (an imaginary futurist position) to make the appropriate arrangements, thereby ensuring that your death gives life.

Alas.

Canada’s Way Forward

Organ donation seems to be a last bastion for change within the assisted dying movement. Canada is to be congratulated for going it alone in following the Benelux lead. This country is proving innovative and progressive when it comes to tweaking its end of life law to accommodate the needs of its citizenry.

As of March 2021, to qualify for help a person no longer needs to have a death that is ‘reasonably forseeable’ (a criteria which in other jurisdictions is translated as < 6 months to live and which is hugely problematic).

This expansion of qualifying criteria opens the way for people with disabilities and other conditions that have no clear prognosis but which make one’s life so miserable that a dignified death has become a preferable option.

Finally, the recent Bill C-7, via a new sunset clause, leaves the way open for people suffering from mental illness to be able to ask for help to die.

In Canada, unlike in the Netherlands and Belgium, a request to die can still not be included in an Advance Health Directive and nor can people who have ‘completed life’ or are ‘tired of life’ ask for help to die.

Finally, there is nothing in these legislative changes that take the decision-making away from the medical profession.

There is no Dutch-style Completed Life Bill which advocates that all people over 70 years of age should be able to be issued with Nembutal so that they can make their own end of life decisions should the need ever arise.

In this regard, there is no place like Holland!

March 7, 2021

The First Place in the World

 Very Brief History

On 1 July 1995, the Northern Territory of the Australia became the first place in the world to pass an assisted dying law.

The Rights of the Terminally Ill Act  (ROTI) was that law.

On 1 July 1996, the full implementation of the law occurred.

On 22 September 1996, the law was used for the first time when Darwin local, Bob Dent, who was suffering from prostate cancer, became the first person in the world to receive a legal lethal voluntary injection.

Bob Dent used Exit Founder Philip Nitschke’s ‘Deliverance Machine‘ to set the Nembutal flowing via intravenous infusion (the same process used at Pegasos Swiss Association today).

Philip Nitschke with the Deliverance Euthanasia Machine, Darwin 1996

Timelines

The Northern Territory was the first place in the world because Oregon’s Death with Dignity Act was waylaid by legal action and was not used until October 1997.

The Netherlands’ Termination of Life on Request and Assisted Suicide (Review Procedures) Act was not passed in law until 2001 and was not used until 2002.

This left the little-known, Northern Territory of Australia alone as the first place in the world where a doctor could lawfully assist a dying patient to die.

However, the NT ROTI Law only lasted 9 months before it was overturned by the Euthanasia Laws Act (known colloquially as the ‘Kevin Andrews Act’).

This law came about as a result of a private member’s bill. The sponsor of that bill was the conservative, catholic Liberal Party MP from the Melbourne seat of Menzies, Kevin Andrews.

This is to say that Andrews used an historical quirk in the Australian Constitution (section 122), which allows the Federal Parliament to make laws for the Territories of Australia (the Northern Territory, the ACT and Norfolk Island).

Put simply, the Euthanasia Laws Act disallowed Australia’s Territories to make laws on voluntary euthanasia. Despite being the first place in the world, the NT can make laws on anything, but not euthanasia.

Above all, this was a cynical, political and strategic way to deny Australians choice at the end of life and it worked.

The Euthanasia Laws Act was put to a conscience vote and was voted through by both the then conservative Prime Minister John Howard and the Leader of the Opposition, Kim Beazley.

Tony Burke (now Manager of Opposition Business, ALP) joined with Kevin Andrews in voting down choice.

National Day of Shame March, Canberra 26 March 2007

In 2021, some 26 years later, there is finally a push underway for the Euthanasia Laws Act to be amended.  Most importantly, this time, the Murdoch press is behind the push.

In the Northern Territory News this week, a full 4 days of lead articles urging the Federal Parliament of Australia to act.

Yes, it is indeed time …

NT News Front Page, 1 March 2021

Why was the Northern Territory the First?

In Killing Me Softly: Voluntary Euthanasia and the Road to the Peaceful Pill (Penguin, 2005), authors Philip Nitschke and Fiona Stewart set out to try to explain why the Northern Territory did it first.

They wrote:

In watching the enactment of VE bills elsewhere in the world since 1997, I have come to realise that certain ingredients are required for the successful passage of a law on VE.

In the mid-1990s in Darwin, we had all that was needed.

For example, we had a charismatic politician who was prepared to stand by his beliefs.

More than this, though, Marshall Perron was something of a legend in the Territory.

His long involvement with Darwin gave him unique insight into the Territory psyche; something he was able to put to good use as he carved out his successful political career.

Perron is also a straight talker.

He doesn’t mince words and can be a powerful force in any debate. He has that admirable talent of taking the people with him.

A politician from the conservative side of politics, his leadership on VE reinforces the fact that the issue is beyond party politics. One’s right to die transcends political divisions and ideological differences.

A second factor in the initial success of the ROTI Bill in the Northern Territory parliament is that they have no upper house.

This makes the passage of legislation more efficient.

The government of the day is all the more powerful when the checks and balances of the house of review of the traditional Westminster system are absent.

This was the case in 1995 in the Territory and it worked in voluntary euthanasia’s favour.

A third factor that helped get the ROTI Bill through is that the Northern Territory is the least religious place in Australia.

According to Social Trends 1994, 18 per cent of the Territory’s population consider themselves to have no religion.

This compared to 10 per cent in New South Wales and a national average of 12 per cent. Territorians are also the most likely people to leave the religion question in the census unanswered.

Finally, the Territory has a mindset that is different from everywhere else in Australia.

In this part of the world, car registration plates contain words like ‘Frontier’, ‘Barra Country’ and ‘Outback’ – words that conjure up Territory fact and myth. And this is the point.

Territorians can be rough, rugged and cynical as hell about the gentrified south.

In some ways, the Territory welcomed a VE law precisely because no one else had one. No other state or territory was tough enough to find a legislative way to deal with this political hot potato.

Demonstration in Canberra, March 2007 on the 10th Anniversary of the overturning of ROTI Act