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Doctor aids first legal euthanasia act

BMJ 1996; 313 doi: https://doi.org/10.1136/bmj.313.7061.835 (Published 05 October 1996) Cite this as: BMJ 1996;313:835

The controversial general practitioner who helped a 66 year old patient with cancer become the first person in the world to die under euthanasia legislation says more deaths could follow soon. Northern Territory doctor Philip Nitschke said that five more people, including three from the southern states, were seeking to die under the territory's Rights of the Terminally Ill Act.

The death of former carpenter Bob Dent, who used a computer operated machine to administer a lethal dose of drugs on September 22, has provoked an ethical storm around Australia. However, the Northern Territory's bill, which came into force only in July, could still be overturned by a private member's bill due to be debated in the federal parliament later this month. It is also set to be challenged in the High Court.

Deputy prime minister Tim Fischer said: “What might be one deliberate death in Darwin this week has the capacity to be a good deal down the path worldwide.” The head of the Catholic Church in Australia, Cardinal Edward Clancy, said: “Euthanasia is an ugly thing. It has two names—either murder or suicide.”

Mr Dent, who developed prostatic cancer in 1991 and had both testes removed, said in a last statement dictated to his wife: “If I was to keep a pet animal in the same condition I am in I would be prosecuted.” He said that he had lost 25 kg in weight and could not even get a hug in case his ribs cracked.

His life ended after he answered three questions on a laptop computer, supplied by Dr Nitschke, and hit the space bar. Then three drugs (thiopentone, pentobarbitone, and atracurium) were administered through an intravenous line into his arm.

The “death machine,” as it is dubbed by “right to life” groups, gives the patient control over the time of death and means a doctor does not directly have to administer the fatal dose. Dr Nitschke said afterwards, “It [voluntary euthanasia] takes a toll out of those people who are participating. But perhaps ultimately it is the greatest thing you can do for a person. I felt at the end of it enhanced by the experience. I did not feel in any way that I have done the wrong thing.”

Previous attempts to use the legislation have failed because of its strict safeguards. Three medical signatures are required, including that of the general practitioner, a specialist in the subject to confirm that the condition is terminal, and a psychiatrist to certify that the patient is not suffering from clinically treatable depression. There then has to be a seven day waiting period, when the patient has to answer more questions, and then a 48 hour “cooling off” period.

Figure1

Dr Philip Nitschke said that euthanasia is the greatest thing you can do for a person

The Australian Medical Association has opposed the legislation on the grounds that it does not believe laws to permit euthanasia should be in place, although it admits that euthanasia occurs.—CHRISTOPHER ZINN, Guardian correspondent, Sidney

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