Damned if I Do

by Philip Nitschke

  The politics around the Clem Jones legacy brought out the worst in the movement. The public spectacle of ­internal squabbling among those who are essentially on the same side, with groups denouncing one another on the basis of mistruths and smear was in no one’s interest. The South Australian Voluntary Euthanasia Society took the prize, printing on all the newsletter bannerheads and on their ­website that they are ‘not affiliated with Exit International/Dr Philip Nitschke and opposes [sic] the public availability of a “peaceful pill”’. The mischievous imputation, of course, is that I’d make a peaceful pill available to all who wanted it, including depressed teens. While I expect such mud-slinging from the religious fundamentalists and Right to Life supporters, pro-choice advocates should know, and act, better.

  The allegation about suicide pills for depressed teens stems from a 2001 interview I did with Kathryn Jean Lopez, for the conservative but influential US magazine National Review.

  Lopez asked me:

  Do you see any restrictions that should 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? What about a troubled teen? Who qualifies? Who decides if a life is worth living?

  I responded:

  This difficult question I will answer in two parts. My personal position is that if we believe that there is a right to life, then we must accept that people have a right to dispose of that life whenever they want. (In the same way as the right to freedom of religion has implicit the right to be an atheist, and the right to freedom of speech involves the right to remain silent.) 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. And someone needs to provide this knowledge, training, or recourse necessary to anyone who wants it, including 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.

  This would mean that the so-called ‘peaceful pill’ should be available in the supermarket so that those old enough to understand death could obtain death peacefully at the time of their choosing. It’s hard to imagine how such a development would affect society, but I believe the impact would not be as great as people fear …

  The final question that needs to be answered though is ‘Whom do I want to help?’ While acknowledging that all have the ‘right’ to receive assistance without fear of legal consequence, I do not personally want to involve myself in helping those who can manage the act themselves. The purpose of the deliverance machine … was to allow the individual to initiate the process and to take the responsibility for their actions. My guidelines for those whom I am prepared to assist are of course arbitrary. In this country, without protective legislation, I could do what I liked, or rather, what I could get away with. 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.12

  From this interview, in which I was philosophising about end-of-life choices, a furore has arisen about what I really meant by my now infamous ‘supermarket shelf’ statement. This interview gave the Christian Right a free kick, but I was much more surprised when those who are supposedly on my side used the same technique to attack me. In mid 2012, the Clem Jones bequest to the voluntary euthanasia movement legally ‘failed’, and the financial playing field is once again level. It is hard work raising the monies required to fund an advocacy organisation on a so-called moral issue like voluntary euthanasia. If, in the future, there is another windfall of this magnitude, it would help immensely if decisions about where money then flows could be decided by the quality of the suggested ideas for change, along with their ability to be strategically implemented. However, I’m not naïve enough to think this will likely be the case.

  Ultimately, criticism of me from within the voluntary euthanasia movement is a distraction (I’m not perfect and my public actions and statements are not always understood, or properly reported in the media). Responding to ­accusations could become a full time job if I let it. But this should not distract me from what is the main game: fighting the real opponents, those who would deny us choice over how we live and die.

  FOURTEEN

  My life with the media

  He must have a long spoon that must eat with the devil.

  William Shakespeare, The Comedy of Errors

  In some ways, I’ve been lucky having been exposed to the media from a relatively young age. If my citizen’s arrest at the age of sixteen years taught me anything, it was that what is reported is not necessarily an accurate description of the facts: an insight that has stood me in good stead ever since. While I might have had some powerful winning media moments on the topic of voluntary euthanasia, I’ve also had some spectacular failures and even stuff-ups. In addition, social media has provided new and undreamt of ways to allow the failures in particular to live on.

  To those on the outside, it seems that harnessing the media on behalf of a social issue such as voluntary ­euthanasia takes nothing more than a phone call to a friendly ­journalist. Exit members are constantly surprised when I tell them I have little or no control over what the newspapers write about me or the debate more broadly. I find myself ­forever explaining that ‘Yes, it was unfortunate that “Cheryl” from The Australian missed this or that vital point’. Or that she failed to mention Exit by name. Or that this or that politician has now gone back on their word. Although often annoying, as the writer WH Auden once remarked, what the mass media offers is ‘entertainment which is intended to be consumed like food, forgotten, and replaced by a new dish’.

  Over the past fifteen years, my experience of, and life in, the media has crossed cultural and language divides. From Russian state television, or cable television in mainland China, to local school children interviewing me for high school assignments. Then there has been US primetime news on CNN with the ruthless Connie Chung and the outright sensationalism in the UK’s now-defunct News of the World. In all I have been propped up, shot down, admired and loathed. Sometimes the voluntary euthanasia issue wins out, and my point has shone through; the focus is on the message, not the messenger. At other times though, I have been depicted as a murderous, bloodthirsty doctor who is getting filthy rich on killing innocent elderly members of the community. ‘Aren’t you making a lot of money out of death?’ is a question BBC journalists, in particular, seem concerned with.

  The angles the media have covered have ranged widely, as have the large number of Exit members who have bravely spoken out prior to ending their lives: Chris Rossiter, Don and Iris Flounders, Angie Belecciu, Dr John Elliott, Steve Guest, Lisette Nigot, Sandy Williamson, Norma Hall, Jay Franklin, Angelique Flowers, Nancy Crick, Caren Jenning, Susan Potts and many, many others. Issues covered include the four deaths of my patients under the ROTI Act, Exit workshop and meeting venue closures, the banning of The Peaceful Pill Handbook and television advertisements, and DIY technologies such as my Nitrogen system (marketed as Max Dog Brewing ­cylinders—Max being a rather gormless red heeler dog that a good friend of mine owns). And then there has been the police raids on Exit’s Australian offices, trips to Tijuana with terminally ill Exit members, internet hacking workshops, Nembutal test kits, teenage deaths from Nembutal, court trials, parliamentary apologies, and street demonstrations and protests. In only a small minority of these events have I been able to set the agenda and watch the media blindly follow. Invariably one finds oneself buffeted by the media wind, with little certainty of the eventual outcome. Nowhere was this
more obvious than in 2004, with the death of Gold Coast grandmother Nancy Crick from a Nembutal overdose.

  The fall-out from Nancy’s death continues to this day; media reports ensure that she is remembered as the granny who was tricked into thinking she was terminally ill, and then helped to die. My role in the ‘cover-up’ was in telling the media she had bowel cancer when I should have stressed that she was in fact suffering from the effects of ­‘successful’ cancer surgery, thus explaining why the quickie autopsy by the Queensland Coroner’s office showed she had died ‘cancer free’. Who could blame the person in the street for being more than a little confused?

  In Killing Me Softly, I wrote about the circumstances of Nancy’s death in some detail. I wrote, too, about the political opportunism of any number of commentators, and in ­particular, the then Queensland Premier Peter Beattie.

  My efforts to pitch Nancy’s story to a variety of media worked well. The press releases were picked up and run with, and the strategically placed phone calls to a chosen few ­journalists had their desired effect. It was a story with a very human face. Here was your sixty-something battler, a retired ­barmaid from the working-class suburb of Brunswick in inner Melbourne. Nancy had seen a lot of life, and had more than her share of bad luck, with her husband, Jimmy, dying just as they both should have been enjoying their retirement in the sun.

  The coverage of Nancy’s story about wanting to die grew organically and she was fast on her way to ­becoming a household name, presenting a hard-to-argue-with case as she spoke to local and national newspapers, and appeared on Channel 9’s A Current Affair. We held a public meeting on the Gold Coast, and Nancy even launched an internet diary, with which she was in touch with an ever-increasing number of friends and strangers (including a hospice patient in Venice, a farmer in the US and even a fisherman from the Falkland Islands) about her quality of life, her plans for the future and whether or not she would take that final step.

  While I was happy enough for the media to follow Nancy’s every move while she was alive, common sense told me that media presence on the day of her intended death was always going to be tacky. Who wants to die on film? Who wants their death to be a tabloid sensation, and fodder for breakfast- and dinner-table chat throughout the nation (and the world)? Once Nancy had decided on the time and day, the management of the media became of particular concern. To gain some control I leaked that there was a range of pos­sible dates. Subterfuge became the name of the game as I tried to shake the media’s now-obsessive focus on Nancy’s pending death. At this point, a number of us from Exit even bought prepaid mobile phones, so our planning conversations would be kept private from both the media and the police.

  In one way, I was successful, Nancy died at home in ­private, surrounded by those twenty-one people she cared about. No one ever discovered just where, or when, she acquired her Nembutal, although this was not the point. Nancy wanted her death to mean something. She wanted to challenge the law. She wanted to know if those who were with her when she died would be charged with assisting her suicide, simply because they were present when she took that final step. This was a question I also wanted the Queensland authorities to address. Many people want those they love around them when they die, but no one wants their family subject to legal risk by so doing. Clarification of what does or does not constitute ‘assisting’ is important. Unfortunately, the unexpected aftermath of Nancy’s death has left this ­question unanswered.

  After months of micro-managing the media around Nancy, all hell broke loose. My image, as the caring human rights activist, was reinvented as a duplicitous manipulator who would stop at nothing for his own self-aggrandisement.

  In Killing Me Softly, I wrote:

  Nancy’s death was bound to be a high-profile, political affair. Despite this fact, few could have foreseen the way in which the preliminary results of her autopsy would be leaked to the public in an attempt to damage my reputation. I learnt of the leak when I received a phone call from a senior journalist with The Courier-Mail newspaper just forty-eight hours after Nancy’s death. His comments shocked me. ‘Very reliable sources’, he said, had leaked to him the news that a government pathologist at Brisbane’s John Tonge Forensic Centre had reported he could find no trace of cancer in Mrs Crick’s body. ‘This,’ he said, ‘changed everything.’

  What wasn’t discussed was the fine distinction between suffering from ‘having cancer’ and suffering caused from the major surgery needed to remove the cancer. Did the surgery get all the cancer? This question was never addressed, and nor was the issue of the abdominal adhesions, the painful scarring that was left after her ‘successful cancer surgery’.

  But, to me, what was most shocking was that an autopsy had been arranged so quickly, and that the ‘results’ of what could only have been the most superficial of examinations were at The Courier-Mail before Nancy’s body had cooled. Autopsies take time to arrange and time to execute, and it takes weeks to carry out the microscopic, histological and biochemical examinations necessary to establish accurately a cause of death. And, besides, test results are confidential until the coroner makes his or her decision about the need, or ­otherwise, for an inquest. So, how did it happen that just three days after Nancy’s death the major Australian ­newspapers began running the headline ‘Crick Died Cancer Free’?1 There was a stench about this; influence had clearly been exercised at the highest level.

  To this day, I think it is of little importance whether Nancy still had her cancer when she died; suffering is suffer­ing. Nancy also saw the question as being of little significance, and I think certain media representatives found it convenient to ignore the fact that even Nancy was ambivalent about her actual status regarding the cancer. Two months before her death, in an interview with journalist Leisa Scott in The Weekend Australian, Nancy had said:

  I don’t know what I’ve got and they don’t know what I’ve got, but whatever it is, it’s bloody well there. And they can’t find it with their operations and in the end it comes down to quality of life and I’ve got none of that now. Those who keep telling me what to do aren’t going through what I’m going through. It’s not up to the politicians, or the church or the doctors, it’s up to the people, and it’s up to the patients. Why don’t they ask the people?2

  But for a government embarrassed on an almost daily basis by this suffering woman and her public diary and wanting to hide its own inadequacy, and a society preferring not to have to deal with the awful reality that life after ‘successful’ cancer surgery can be worse than the cancer itself, truth was of little importance. Many media reports condemned me. The AMA’s deputy president, Trevor Mudge, sermonised that ‘you have to look at the quality of the advice she’s been offered’, while other nameless ‘leading surgeons’ were said to have ‘expressed concern’ about my diagnosis.3 I was being portrayed as a person who had used Nancy and her family to serve my own ambitions, and, even worse, to have lied to the Australian public.

  Of course, none of these accusations were true, as the article in The Weekend Australian had made clear. No one had known exactly what the situation was with Nancy’s health. All we knew was that she had a problem and that she—not I—felt her life was not worth living as a result. Yet, the Queensland Premier of the day, Peter Beattie couldn’t resist the opportunity to sink the boot in, stating, ‘I just say to the learned doctor, you’ve got a lot of explaining to do’. He then went in for some more point scoring, suggesting that ‘legalised euthanasia could be misused by some people to attempt to murder their relatives’.4

  The stress of the attacks from the media, and from Beattie and the AMA, was huge, but at this most difficult time, Marshall Perron came to my aid. As someone with many years experience in the head-kicking and back-stabbing that is Australian politics, he rang me and simply said, ‘Don’t be too discouraged. You only cop this sort of flak when you’re over the target.’

  I spent quite a bit of time in the days
that followed, feeling sorry for myself and licking my wounds. In retrospect, it’s clear that I should have publicly stressed to a much greater degree that I didn’t know, and indeed, it didn’t matter to Nancy, whether it was the cancer or the cancer treatment that had destroyed her quality of life. The point was, with no quality of life and no relief in sight, death, in her view, had become the best option. I was again made to realise that when you tangle with powerful forces, and with people used to playing the dirty games of politics and power, you can really get hurt. What was also made crystal clear to me was that governments will do everything they can to destroy the integrity and credibility of those who draw attention to the administration’s inadequacy. And they will do just about anything but engage with the issue of our collective right to determine our own end-of-life choices. Although it was Nancy who drew attention to the failings in Queensland law, the Beattie government could not attack her; this would be unacceptable. Better, they thought, to target me.

  After Nancy died, it wasn’t long before the Queensland police embarked on the lengthy and expensive investigation that led to simultaneous police raids across three states in search of computers, documents and videotape ­associated with Nancy. Early one morning several squad cars screeched down my driveway in Darwin. I was greeted by plain-clothed officers in sunglasses, bolt-cutters in hand. It was just like in the movies. The only thing was that, being in Darwin, the police were overly enthusiastic in the execution of their search warrant, seizing a great deal more material than the warrant permitted. This led to a successful legal action against the Queensland government and the police commis­sioner, Bob Atkinson, by our lawyers, led by John Tippett QC. In the wash-up, the Queensland government was forced to pay our considerable legal costs, which came in at around $40 000. Nice work, I thought.