When Jane was diagnosed with a muscle-wasting disease five years ago, she was active, physically healthy and had a full-time job. Today, the 70-year-old, who has asked her real name not be used, weighs just 92 pounds. She had to give up her job last year after her foot slipped between the brake and the accelerator on the drive home from work one day; she didn't notice until the car swerved. "I thought I should stop driving before I kill someone," Jane says, from her home in Australia. "As for killing myself, I wouldn't mind."
Jane's disease, a form of severe peripheral neuropathy, means that most times when she sits or stands, she is in pain. Soon, she'll lose the ability to walk and eventually to speak. Painkillers haven't helped — she is in agony if she so much as bumps against a table leg — and her days go by slowly. Like many who suffer from chronic degenerative diseases, Jane says that if euthanasia were legal in Australia, she would take the opportunity to die. "I think of death as peaceful."
If she was ill in 1996, then her wish may have been granted. That year, the Rights of the Terminally Ill Act came into effect in Australia's Northern Territory, under which four people chose to end their lives with the help of physician Philip Nitschke and his computer-aided consent system dubbed "the deliverance machine." Religious groups were outraged, and demanded the law be repealed. The Australian Medical Association also issued a statement that physician-assisted suicide was unethical. Within less than a year, the act was overridden on a legal technicality based on the Northern Territory not being a state. Nitschke, and his pro-euthanasia organization Exit International have been trying to reverse the decision ever since.
Drafting euthanasia legislation has always been a minefield. Questions over whether the practice itself is ethical, whether it should be exclusively for those that are dying, who should make the decision to grant someone the right to die, and how to ensure that patients aren't pressured by family members into assisted suicide are difficult to cover in any law. It's legal in a number of countries including Holland, Belgium, Switzerland, and Luxembourg. In Oregon, Washington and Montana, physician aid in dying is allowed, whereby the medication is prescribed by the doctor but must be administered by the patient. The Dignitas clinic in Zurich is the only place in the world where foreign citizens can go to die, and those that do do not have to be terminally ill. In 2009, Daniel James, a British 23-year-old who was paralyzed after a rugby injury, flew to Switzerland to die with the help of his parents.
This year, Nitschke, who has advocated for euthanasia abroad, might succeed in bringing the practice back to Australia. In March, the Premier of Tasmania Lara Giddings told The Australian that she will be working with the Greens Party on preparing a new bill for voluntary euthanasia. (A bill that was proposed last year by the Tasmanian Greens failed in the state's House of Assembly.) For Nitschke, Giddings' move is historic. "[She is] the first premier to really taken a strong position in supporting euthanasia," he says. In the state of South Australia, another bill put tabled in March by Labor Party MP Stephanie Key would provide a legal defense for doctors that administer medication requested by the patient which could lead to their death. The bill wouldn't make assisting suicide legal per se, but it would provide a legal protection for medical practitioners. A final vote on this is expected later this year.
Advocates of euthanasia say the law is long overdue in Australia. "We would be charged with animal cruelty if we treated our pets this way," says Frances Coombe the president of the South Australian Voluntary Euthanasia Society (SAVES). "We need legislation that will allow us to at least talk about death and address our end of life options." Coombe's organization does not work with Nitschke, and although she supports the help he provides for those that are desperate she often feels that on occasion he hurts the cause with his headline-grabbing behavoir. On a recent visit to Adelaide, for instance, the media widely reported that Nitschke was publicly scouting locations for euthanasia clinics. "This feeds into the minds of the opposition and encourages hysteria," says Coombe. Her group is not the only one to feel that he goes too far: Nitschke says that the Victoria-based group Dying with Dignity also broke ties with him because he supports euthanasia for those who aren't terminally ill.
Further points of controversy around Nitschke's work have been his "Peaceful Pill Handbook," a guide to euthanasia and assisted suicide which is now banned from Australia. His organization's website also used to feature a video called "Do it yourself with Betty" in which Betty, a retired nurse, demonstrates how to make an 'exit bag,' a large-sized oven bag with a drawstring for suffocation. "If you want to look nice you better go get your hair done, because this does mess your hair up," she jokes after she threaded elastic through the bag. Then there is the barbiturate testing kit, still sold on his website which helps people test that their dose of medicine is lethal enough. "Terminally ill people don't have time to fool around," he explains.
Some legal experts are concerned at the prospect of euthanasia again being legalized down under. Andrew McGee, a law lecturer at the Queensland University of Technology in Brisbane, believes it may encourage suicide in those that wouldn't otherwise consider it. "There are people in nursing homes that already feel like a burden. ... They already feel guilty and embarrassed but cannot help themselves because of their distress and acute discomfort. They may be made to feel that they should end their lives so as not to feel a burden." HOPE, an anti-euthanasia network, shares McGee's concerns. "It will end up hurting those that are most vulnerable," says Paul Russell, HOPE's director. And, he adds, "There could be circumstances where it will be applied without the consent of the individual."
Still, Nitschke is not without his supporters. Since 1996, euthanasia has become more accepted in Australia: a 2007 Newspoll found that 80% of Australians now support voluntary euthanasia. When he last gave an Exit International talk in Sydney, the mostly elderly crowd of 130 people cheered at his accomplishments, and laughed at his jokes. When speaking to TIME at a cafe in Sydney's Kings Cross, a young man walked past to congratulate him for his good work. "I just want people to have a choice," Nitschke says. "For all I know, I will want to exhaust every medical intervention possible, no expense spared, to give myself an extra ten minutes. I don't know, but I want the right to decide for myself."