“I see [technology] as important in democratizing the process and demedicalizing the process,” says Nitschke, adding the Sarco is not reliant on heavily restricted drugs to operate. “So all of those issues are ways to make the process more equitable.”
In Switzerland, where the Sarco was used, Nitschke’s arguments about access to assisted suicide are not particularly radical. Residents and visitors can already access assisted suicide even if they are not terminally ill. But in Nitschke’s adopted home country of the Netherlands, the Sarco reflects an ongoing debate about assisted suicide’s place in a medical system that dictates only people facing unbearable suffering or an incurable condition can proceed. Nitschke also believes the promise of machines is to take the burden away from the doctor. “I’m passionate about a person’s right to have access to help-to-die, but I don’t see why they should turn me into a murderer,” says Nitschke, who earned a medical degree in 1989.
Theo Boer, who spent nine years assessing thousands of assisted suicide cases on behalf of the Dutch government, disagrees that gatekeepers are a bad thing. “We cannot just leave this to the market,” he says, “because it is dangerous.” Yet he is more sympathetic to Nitschke’s point that doctors should not be burdened with the emotional stress in countries where assisted suicide is legal. “Even though what he does is weird, it contributes to the much needed discussion in the Netherlands, whether or not we need this heavy involvement of doctors,” says Boer, who is now a professor of health care ethics at the Groningen Theological University.
“We cannot burden the doctor with solving all our problems.”
For three decades, Nitschke has been an agitator in the right-to-die debate. “He’s a provocateur,” says professor Michael Cholbi, founder of the international association for the philosophy of death and dying. Cholbi is skeptical about whether the Sarco would ever become normalized, but he believes Nitschke’s creation, even if it strikes some as irresponsible, raises important questions. “He’s trying to catalyze a perhaps difficult conversation around people’s right to access suicide technologies,” he says.
Now 77, Nitschke first explored the idea of delegating assisted suicide to machines in the 1990s. After Australia’s Northern Territory became the world’s first jurisdiction to legalize the process, Nitschke was preoccupied with the risk people would see him or his colleagues as “some evil doctor delivering lethal injections to a moribund patient who didn’t know what was happening,” he says.