“I see [technology] equally important for the democratization and demedicalization of the process,” says Nitschke, adding that Sarco does not depend on highly limited drugs to work. “All of these issues are ways to make the process more fair.”
In Switzerland, where Sarco has been used, Nitschke’s arguments about access to assisted suicide are not particularly radical. Residents and visitors can now benefit from assisted suicide, even if they are not terminally ill. But in the Netherlands, Nitschke’s homeland, Sarco reflects an ongoing debate about the place of assisted suicide in a medical system that dictates only people struggling with unbearable suffering or an incurable disease can continue. Nitschke also believes that the machines will lend a hand reduce the burden on doctors. “I support the human right to access assisted dying, but I don’t understand why they would make me out to be a murderer,” says Nitschke, who received his medical degree in 1989.
Theo Boer, who has assessed thousands of assisted suicide cases on behalf of the Dutch government for nine years, disagrees that gatekeepers are a bad thing. “We can’t leave it to the market,” he says, “because it’s risky.” However, he is more sympathetic to Nitschke’s argument that doctors should not be burdened with emotional stress in countries where assisted suicide is legal. “Although what he is doing is strange, it contributes to a much-needed discussion in the Netherlands about whether we need so much physician involvement,” says Boer, now a professor of health care ethics at the Theological University of Groningen.
“We can’t put the burden on a doctor to solve all our problems.”
For thirty years, Nitschke has been an agitator in the debate about the right to die. “He is a provocateur,” says Professor Michael Cholbi, founder of the International Association for the Philosophy of Death and Dying. Cholbi is skeptical that Sarco will ever be normalized, but he believes that Nitschke’s work, even if it seems irresponsible to some, raises important questions. “It’s trying to catalyze what is perhaps a difficult conversation about people’s right to access suicide technologies,” he says.
Nitschke, now 77, first came across the idea of delegating assisted suicide to machines in the 1990s. After the Northern Territory of Australia became a world territory First with jurisdiction to legalize the process, Nitschke was concerned about the risk that people would see him or his associates as “an evil doctor giving lethal injections to a dying patient who didn’t know what was happening,” he says.