The 85 year old woman still had a strong German accent. She had, she told me, been living in Australia since the end of the war when she arrived as a refugee from Germany. Now Helga wanted help, wanted to attend my free euthanasia advisory clinics, wanted to get access to lethal drugs so that she could control the time of her death. I gave her an appointment for the next Sydney clinic, and hung up.
I met her a few weeks later and she told me her story; how it was that she had come to this point. As a 22 year old Jewish woman, she was studying medicine in Warsaw when war broke out. When the Nazis invaded Poland, she found herself and her 2-year-old child incarcerated in a concentration camp, separated from her husband. Her expression was flat and detached as she described how her child had died, but how she, because of her youth and fitness, had been able to work and survive those war years. In Europe, at liberation, she found herself alone, her husband dead and with no-one else from her family alive. She travelled to Australia, and had worked for the next 35 years in a Sydney clothing factory.
She was not terminally ill. In fact, by any conventional measure, she was not ill at all -- just someone who wanted to know she could peacefully end her life at the time of her choice. She asked me for the drugs she wanted. "Barbiturates", she said, "something that will give me control..." I raised my hands, stopping her in mid sentence. "Can't do it", I said, "it's against the law to assist in a suicide. And you're not even ill -- to help you would be to take extreme risks". It was her turn to stop me. "Risks!" she exclaimed, with more than a hint of sarcasm, "I'll tell you about real risks in life". She continued. "Do you think I'd be asking you for help if I'd been able to finish medicine? Do you think I'd be coming to you, begging for help? And I'm not after that much, I just want what I would have had, if life had been different. What I want is what you've got, something that will allow me to control the time of my death."
This month, I described the story to medical and nursing staff in a Perth hospital. I wanted to use Helga's story as an example of one of the groups of people who are increasingly attending my euthanasia advisory clinics. In a clinic series, run in August/September of this year in four Australian cities, 44 patients were seen, 57% of whom were not terminal, and 12% (five patients) were not ill at all, but simply wanted to have the piece of mind that comes from having access to peaceful lethal drugs. In December this year, a second run of clinics will be held across Australia and another 34 patients will be seen. Slowly the profile of a typical clinic attender is being compiled.
The results are encouraging; a seeming paradox. Those who are able to get help and obtain what they want, information, drugs, advice etc., immediately become less anxious. A preoccupation, a concern that many of them have had for months, sometime years, evaporates when they are put back in control. The terminally ill feel better, their quality of life improves, they can relax more, and they probably live longer. This then is the paradox: access to good euthanasia legislation, or in the absence of this, the chance to obtain advice from these euthanasia clinics, does not lead to the premature deaths of the terminally ill. Access to clinics results in the sick living longer, better lives. And patients like Helga, people who simply want to know they have control over this most important decision, benefit from the peace that comes when this need is met. Surely these are results of which a medical professional should be proud.
Unfortunately, my opponents do not see it this way. Groups that purport to care for the rights of patients continue to oppose the clinics and to lobby the various medical boards for my deregistration. In three states, challenges have been made from such bodies as 'Right to Life', 'Coalition for the Defence of Human Life', 'Trust', and of course the 'Australian Medical Association'. Plans for a comprehensive series of free clinics in locations that will include Hobart and Perth are now in place for the year 2000. Whether they survive or not is yet to be seen...
Philip Nitschke, MBBS, PhD. Darwin, November 1999.