When someone with a terminal illness decides to end his or her life by overdosing on barbiturates, they may hope the drugs will lull them into a peaceful and permanent sleep. But if the drugs have passed their expiration date or lack a sufficiently lethal concentration, the would-be suicide victim may actually survive — risking an array of complications including coma, reduced physical functioning and the opprobrium of disapproving friends and family. Now, in an effort to provide certainty to those contemplating suicide, one of the world's leading euthanasia advocates plans to sell barbiturate-testing kits to confirm that deadly drug cocktails are, in fact, deadly.
"People who are seriously ill don't want to experiment," says Dr. Philip Nitschke, the physician known as Dr. Death for his efforts to legalize euthanasia in his native Australia. "They want to know they have the right concentration of drugs so that if they take them in the suggested way, it will provide them with a peaceful death."
The kits, which will debut in Britain in May and retail for $50, include a syringe that allows users to extract half a milliliter of barbiturate solution without breaking the sanitary seal. "Clearly, sterility doesn't matter given that death is the desired outcome," Nitschke says. But the solution deteriorates slower in a sterile environment, allowing those with painful conditions to "lock it away in the back of the cupboard in case things gets too bad." The extracted sample is then mixed with chemicals from the kit; a color change indicates a lethal solution. (See pictures of suicide in the U.S. Army recruiters' ranks.)
Nitschke began devising the kits two years ago in response to growing demand from members of Exit International, the organization he runs that distributes information on end-of-life methods. Increasingly, the group's 3,500 members are obtaining sodium pentobarbital, a clear solution used to anesthetize cats, dogs and horses, from online sources based in Mexico and Southeast Asia. "For whatever reason, the suppliers have been taking off the label when they ship it," Nitschke says. "People want reassurance they've not just bought a bottle of water."
That hardly justifies a suicide test kit, say anti-euthanasia groups, who are up in arms about Nitschke's move. "Nitschke is an extremist and a self-publicist," says Peter Saunders, director of Care Not Killing, an anti-euthanasia group in London. "He will prey upon vulnerable people with these kits, and as a result they won't get the medical treatment and proper palliative care that they really need."
Others fear that healthy elderly people will feel pressure to end their lives, to avoid becoming a burden to their families, and that the kit will lead to a spike in suicides. But Nitschke argues that access to a test reduces anxiety among those who want to know they have a peaceful way out of life should they ever need it — even if they never will. By helping them worry less, the kits, he says, may boost the quality, and length, of a person's life. "That's reassuring and empowering, and it also gives them cause to stop and think before acting," he says. (See pictures of suicide at Jonestown.)
But that reasoning gives even pro-euthanasia groups pause. "We think that his actions are irresponsible and potentially dangerous," says James Harris, head of campaigns and communications at Dignity in Dying, which is working to amend the U.K.'s law on euthanasia. "Does he know if these people have talked to their doctors? Are they competent to make this decision? It completely baffles me."
In recent months, Nitschke has become an increasingly visible — and divisive — figure in Britain despite living in Australia. In October, he provoked outrage by holding a workshop in London, attended by 50 people, on how to commit suicide. A second workshop in Bournemouth was canceled after local authorities intervened. And on March 30, Nitschke joined historian and Holocaust denier David Irving as one of the very few speakers to have their invitation to debate before the Oxford Union revoked. Fellow panelists in a planned euthanasia debate had refused to speak alongside him. (Read a TIME story on Irving.)
Next month, Nitschke will stage more suicide seminars in the U.K., and his first webinar on suicide for people who can't travel to Britain. He plans on taking his road show to Los Angeles and New York City in November.
Nitschke says he has chosen Britain as a battleground because of the nation's "enlightened" attitude. The most recent poll on euthanasia by the London-based National Centre for Social Research found that 80% of Britains feel the law should allow voluntary euthanasia carried out by a doctor for a patient with a painful, terminal illness like cancer.
Nitschke is even contemplating moving to Britain permanently. "It's getting very, very uncomfortable in Australia," he says. After he successfully campaigned to make voluntary euthanasia legal in Australia's Northern Territory in July 1996, the law was overturned by Australia's senate eight months later, after four people took their lives. Since then, the government has banned Nitschke's Peaceful Pill handbook, and legislation is currently passing through the parliament that would make it illegal to distribute information about assisted suicide via e-mail and the Internet. Britain's House of Lords is also reviewing legislation that would make it illegal to promote suicide via the Internet.
Sarah Wootton, chief executive of Dignity in Dying, believes that Nitschke has gone too far but says his behavior is a function of a system that fails to address the needs of people living in pain. "The answer is not DIY kits or books, but a fully safeguarded law that protects the vulnerable and gives terminally ill adults the choice of an assisted death. Regrettably, without such a law, activism like this is likely to continue."