An Outback Physician Ignites ‘Doctor Death’ Controversy in Australia

Dr. Philip Nitschke works out of a large tin shed with living quarters at one end, nestled among bloodwood eucalyptus trees and pandanus palms at the end of a dusty road in Australia’s outback.

It’s an unusual setting for a doctor’s office. But he is an unusual doctor.

When the Northern Territory’s Parliament passed the world’s first law making it legal for doctors, under strict guidelines, to assist in the suicides of terminally ill patients, Nitschke was the only one to do it.

“They’ll call me doctor death,” screams a tabloid headline displayed prominently in his office.

All around the office are newspapers, photographs, cartoons and other clippings on Nitschke’s place at the center of a medical, political and moral storm that raged from the chapels of the Vatican to Aborigines’ campfires.

Between Sept. 22, 1996, and March 1, 1997, Nitschke attached four terminally ill people to a machine he designed and guided them through the self-injection of a lethal dose of drugs.

Then, last March 25, the national Parliament passed a bill overriding the territory’s suicide legislation.

Days later, Nitschke put one of his patients into a coma, at her request, and kept her there with increasing amounts of drugs until she died. Police investigated but have not released their findings.

Like Dr. Jack Kevorkian, the Michigan physician who has roiled a legal and ethical debate in the United States by helping dozens of people kill themselves, Nitschke feels the seriously ill are entitled to help when they choose to end their own suffering.

Nitschke, a 50-year-old general practitioner with a doctorate in physics, says he is not obsessive about euthanasia. He maintains he became involved only after hearing a medical association spokesman’s claim on the radio that “no doctor will be involved” in the territorial law.

He says about one person a week contacts him at his office on the outskirts of the northern city of Darwin asking for help in dying.

“I turn people away every week who have absolutely straightforward and impeccable reasons for getting access to a decent death,” Nitschke said.

Others, whom he believes would have met the requirements of the overturned euthanasia law, he helps.

He won’t say exactly how because “it puts me in the area of illegal activity.” He will say that those helped are no longer alive.

“In each case I decide, ‘Can I get away with this or can’t I?’ If they get help, it is because I think I can. If they don’t, it is because it is too risky.”

Although illegal, euthanasia is practiced in the Netherlands, where prosecutions are not brought if strict guidelines are followed. In Oregon, a law allowing doctors to prescribe lethal drugs to terminally ill patients has been passed but not implemented because of legal challenges.

Several attempts to reinstate euthanasia have gone nowhere in Australia.

One proposal would have made euthanasia a crime but imposed only a trivial penalty for doctors involved. In the national Parliament in December, a motion calling for a referendum on the question was largely ignored. Euthanasia bills in three Australian states are at various stages, but are foundering without major party support.

The head of the Northern Territory government, Shane Stone, says euthanasia may be reinstated if the territory is granted statehood as proposed by 2000. Under the constitution, the national Parliament cannot override state laws.

While the euthanasia law would not reactivate automatically, Stone predicted an “overwhelming majority” of the territory’s legislators would support a new bill. “The law remains on our statute books and it will remain there,” he said.

Nitschke has turned his focus to the development of a “suicide pill,” currently being tested by doctors in Australia, the United States and Canada.

Made from products available from drugstores or supermarkets, the pill would put the means for a painless death “within the reach of everyone who wishes to go down that path,” Nitschke said.

He hopes an announcement about the suicide pill will come soon. “Then it might be time to hang up the syringe.”

Everyone should be “empowered” by having the same access to lethal products as doctors, Nitschke said.

“Why are doctors the only people with this power?” he asked. “Some people will die, but the benefit is that you will not see people living with ongoing bizarre and horrendous suffering simply because they don’t have a piece of information and knowledge that I have because I went to medical school.”