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Proponents and opponents of euthanasia have argued passionately about whether it should be legalized. In Australia in the mid-1990s, following the world’s first legal euthanasia deaths, Dr. Philip Nitschke initiated a different approach: a search for do-it-yourself technological means of dying with dignity. The Australian government has opposed this effort, especially through heavy censorship. The citizen efforts led by Nitschke have the potential to move the euthanasia issue from a debate about legalization to a struggle over technology.
Bulletin of Science, Technology & Society
30(1) 54 –59
© 2010 SAGE Publications
Reprints and permission: http://www.
DOI: 10.1177/0270467609355053
Techniques to Pass On:
Technology and Euthanasia
Brian Martin1
Proponents and opponents of euthanasia have argued passionately about whether it should be legalized. In Australia in the
mid-1990s, following the world’s first legal euthanasia deaths, Dr. Philip Nitschke initiated a different approach: a search
for do-it-yourself technological means of dying with dignity. The Australian government has opposed this effort, especially
through heavy censorship. The citizen efforts led by Nitschke have the potential to move the euthanasia issue from a debate
about legalization to a struggle over technology.
voluntary euthanasia, dying with dignity, technology, self-help, Exit International
1. Introduction
Euthanasia has a long history involving vehement debate
(Dowbiggin, 2005). Present-day proponents argue, typically,
that people have a right to die at a time and place of their own
choosing. Instead of spending their final days in a hospital or
nursing home with the prospect of pain, breathlessness, indig-
nity, and loss of autonomy, many people prefer to die at home
among friends and family, in a dignified way under their own
control at a time of their own choosing. Proponents argue for
legalization of voluntary euthanasia, with tight controls to
ensure consent is freely given and is not distorted by mental
Opponents argue that euthanasia should remain illegal,
because it is too easy to slip down the road to involuntary
euthanasia of people with dementia or other disabilities, as in
the infamous Nazi euthanasia program that killed hundreds
of thousands of people with intellectual and physical dis-
abilities. Opponents point to the alternative of palliative care
that can make dying comfortable and usually pain free.
The arguments for and against euthanasia and physician-
assisted suicide have been examined and argued exhaustively
(Yount, 2007). My aim here is different: to look at the role
of technology within a particular niche of the euthanasia
struggle, with Dr. Philip Nitschke and his organization, Exit
International, the most prominent players. In most conflicts
over euthanasia, technology is a backdrop to legal and ethics-
based debates and campaigns. With Nitschke and Exit,
technology has become a key means by which the campaign
is carried forward and by which opponents have responded.
I start with a brief overview of the background to the current
voluntary euthanasia debate, especially the role of technology.
Then I describe Nitschke’s role in turning to technology as a
better road to voluntary euthanasia, followed by the subse-
quent tactics, mainly in Australia, over access to this road. I
conclude with comments about the implications for under-
standing the role of citizen activism and technology.
2. Death and Technology
Only a few centuries ago, death usually was a natural process:
The body succumbed to disease or accident and that was that.
With the rise of modern industrialized medicine, especially in
recent decades, dying and death are more commonly accom-
panied by technological interventions, including a wide range
of drugs (chemotherapy, anticonvulsants, painkillers, and
many others), operations, transfusions, resuscitation, defi-
brillators, respirators, and feeding tubes. A body that previously
would have died can now be kept functioning for days, weeks,
or even years, as in persistent vegetative states (Colby, 2006;
Nuland, 1993).
Many aspects of advanced medical intervention are widely
welcomed. For example, people can now recover from heart
attacks and live many more years of productive life. How-
ever, high-technology medicine has created a new phenomenon:
the extension of life in a medical environment, often in a hos-
pital or nursing home under constant medical care, with
reduced consciousness and a lower quality of life. Whereas
people previously would die at home as disease progressed,
now their life may be extended through medical interventions.
1University of Wollongong, Wollongong, New South Wales, Australia
Corresponding Author:
Brian Martin, Arts Faculty, University of Wollongong, Wollongong, New
South Wales 2522, Australia
at University of Wollongong on February 22, 2010 http://bst.sagepub.comDownloaded from
Martin 55
Some, seeing this happen to family or friends and fearing a
similar outcome for themselves, see voluntary euthanasia as
an alternative, as a way to achieve death with dignity.
Over the same period that technology has made possible
the extended viability of bodily functions, some opportuni-
ties for easy death have been removed. In the 1950s, it was
easy to commit suicide by overdosing on sleeping pills, espe-
cially barbiturates, and sometimes this happened accidentally.
Marilyn Monroe was the most famous victim. Governments
and pharmaceutical companies gradually removed such drugs
from sale so it is now quite difficult to commit suicide by
overdosing on over-the-counter medications of any sort.
Another factor in reducing deaths from attempted suicide
is improvements in emergency response. Most people saved
by swift and effective interventions have no intention of
dying—for example, they might have suffered a heart attack
but can recover and live many more years or decades. But
emergency response also makes suicide more difficult.
Anyone desperate to die has plenty of choices, such as
jumping from a building, leaping in front of a train, using a
gun, or hanging. None of these methods is entirely reliable.
People with limited mobility may have difficulty leaping in
front of a train or even getting out of a window. All these meth-
ods can go wrong and lead to serious injuries, exacerbating the
agony from which death is the desired release. Most impor-
tantly, these methods are distressing to others, including family,
friends, and train drivers. They do not fulfill basic criteria for a
peaceful death.
Death with dignity thus seems to be becoming less common
for two convergent reasons: rapidly developing technology to
extend life, but under the control of the medical system, and
removal of easy, peaceful ways to end one’s life.
One response has been voluntary euthanasia or physician-
assisted suicide. Euthanasia can be classified in various ways,
including covert and overt. When euthanasia is illegal, it
may still occur covertly (Magnusson, 2002). Typically, a
person with a terminal illness asks a doctor for assistance in
dying, or hints at it, and the doctor increases administration of
painkillers or other drugs with the knowledge that death is
probably hastened. This can also be called “slow euthana-
sia.” In many countries it is not prosecuted so long as the
doctor primarily intended to ease suffering. In some cases
the person is not sufficiently conscious or competent to express
a wish to die, yet family members or the doctor judge their
suffering to be so great as to justify hastening death.
In overt euthanasia, decisions and actions to end life are
made openly. The individual or carers decide that death is the
more humane option and proceed to end life, for example, by
lethal injection. This option is the main focus in the huge
ongoing debate over euthanasia.
In only a few parts of the world has euthanasia been legal-
ized or officially tolerated. In the Netherlands, Belgium, and
the states of Oregon and Washington, laws allow euthanasia
under medical supervision in strictly defined circumsta nces.
In Switzerland, assisting suicide is not prosecuted; Switzerland
is the only country in which foreigners can obtain suicide
assistance legally.
In all these places, legal controls are strict. Nevertheless,
critics argue that these laws open the door to abuse and that
some euthanasia deaths do not satisfy the legal conditions.
3. Australia’s Euthanasia Experiment
Australia, a country the size of continental United States with
a population of 21 million—less than Texas—has six states
and two territories. One of the territories is the Northern Ter-
ritory, a huge area in the center and north of the country
nearly twice the size of Texas but with a population of only
200,000, the majority of whom live in Darwin, a city on the
northern coast in the tropics.
In 1996, the Northern Territory became the first place in
the world where euthanasia was legal (Ryan & Kaye, 1996).
The law was strict, applying only to terminally ill patients
and requiring approval from two doctors and examination by
a psychiatrist. The only doctor willing to take a lead in the
process was Philip Nitschke, who had a long history as a dis-
sident, for example, speaking out about the health risks from
visiting U.S. nuclear warships.
Nitschke rigged up a computer-based system that ensured
individuals had maximum control over their dying. With an
intravenous line in place with a syringe driven by the com-
puter, the dying person had to answer several questions
posed on the computer screen before death-inducing chemi-
cals were automatically injected into their veins. Once the
system was set up, Nitschke could take a back seat and family
and friends could be with the dying person, if desired.
The Australian federal parliament overruled the Northern
Territory law 9 months after it took effect. Just four people
had died using the provisions of the law (Kissane Street, &
Nitschke, 1998). The federal parliament’s action was in the
face of popular support for voluntary euthanasia, with opin-
ion polls showing more than 75% of Australians in favor.
4. The Exit Route
Nitschke was transformed by his experience with the Northern
Territory law. He became disenchanted with the legal road to
euthanasia after seeing how easy it was for a hostile govern-
ment to reverse legal changes. He was also disillusioned by
the lengthy, restrictive process required by the law. He saw
individuals in extreme suffering who could not be helped
because legal requirements could not be satisfied.
The Northern Territory experience spurred Nitschke to
pursue a different path to euthanasia: technology. Rather than
lobby to legalize a process still controlled by the medical pro-
fession, Nitschke—who had a background in experimental
physics before becoming a doctor—began a search to find
ways for people to have full control over their own deaths,
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56 Bulletin of Science, Technology & Society 30(1)
to peacefully die in dignity in a time and place of their own
choosing (Nitschke & Stewart, 2005).
In Australia, it is legal to commit suicide but illegal to
assist someone to kill himself or herself. Doctors routinely
give painkilling drugs that hasten death and sometimes pro-
vide individuals with information and drugs for dying, but
very few are willing to admit to this because of the possibil-
ity of being charged with murder (Syme, 2008). In this context,
Nitschke wanted to find ways that people, mainly those with
terminal illnesses with excessive suffering, could choose death
without implicating others in the process.
Nitschke set up an organization, Exit International, to sup-
port this quest. Most members are elderly, with a personal
interest in having a peaceful death. Members of Exit include
retired engineers, chemists, and others with technical skills
relevant to finding ways to die that satisfy several condi-
tions: the technique allows a peaceful death, it is under the
control of the person dying, and it is reasonably simple and
cheap. Exit’s efforts are part of a wider international quest to
find or develop technology to assist deathing (Ogden, 2001).
One technique—the best discovered so far—is to go to
Mexico, buy pentobarbital, a barbiturate commonly known
by its trade name Nembutal, at a veterinary supply store, and
take a suitable dose. The drug itself is cheap and the trip from
Australia to Mexico not too expensive. The death is quick,
easy, and reliable if instructions are followed.
An even more convenient option would be the capacity to
produce pentobarbital in a home laboratory using commonly
available chemicals and standard equipment. However, thus
far Exit’s efforts toward this goal have been unsuccessful.
Another technique involves what is called an “exit bag.”
In one version of this technique, a bag a bit larger than one’s
head is made according to detailed instructions, with a pull
cord at the opening. A container of inert gas such as helium
is purchased and a controlled-release nozzle fitted. Dying is
achieved by opening the inert gas nozzle, inflating the bag,
exhaling, pulling the bag down over one’s head and taking a
deep breath, which quickly causes unconsciousness followed
by death minutes later. Care has to be taken, for example, not
to make the bag too tight. This technique is cheap and the
equipment is not overly complicated. However, the technique
required is a bit tricky, especially for those who are very ill or
disabled, which means it is not entirely reliable. More impor-
tantly, most people find it less appealing than Nembutal,
feeling it is undignified to die with a bag over your head.
A more conventional approach is to ask your doctor for a
prescription of barbiturates or some other drug that will assist
in ending your life. However, some doctors are unsympa-
thetic or afraid of being charged as an accomplice. Therefore,
Nitschke recommends making the request for lethal drugs
sound sincere. Instead of asking for 100 mg propoxyphene—
which sounds suspiciously well-informed—it might be better
to say “Could I have some of that pain reliever my friend said
was so good? I think it started with a D.” The doctor may then
provide Darvon—the U.S. trade name for propoxyphene.
Obtaining tools for suicide by verbal techniques could be said
to be a form of “human engineering,” namely, using social
techniques to achieve objectives, in this case objectives
involving technology in the form of drugs.
Nitschke and other members of Exit are constantly
searching for better information about use of these and other
techniques. For example, rather than building the exit bag
nozzle for themselves, people can now buy nozzles that fit
commercially available helium canisters. When helium can-
isters became unavailable in Australia, Exit recommended
nitrogen as an alternative.
The activities of Exit have attracted attention, mainly
through media stories about members who have ended their
lives, often with Nitschke’s advice and assistance in obtain-
ing materials. As Exit has developed its techniques and spread
its message, euthanasia opponents in the Australian govern-
ment have tried to hinder these activities. The result has been
a sort of game or race, with each side trying to find means—
technological or otherwise—to advance its goals.
5. A Sociotechnical Struggle
The Australian government’s primary response was to pass a
law against giving information about how to commit suicide
using any electronic communications medium, including tele-
phone and the Internet. This is the most draconian law in the
world against providing information about how to kill one-
self. For example, if you tell someone over the telephone
how to tie a rope for hanging, in principle you could be pros-
ecuted under the law. In practice, conversations like this are
not the target of the law: It is aimed at Exit’s activities.
Exit responded by hosting its Web site in the United States
and putting its telephone help line in New Zealand and later
relying on Skype for calls because it is hard to intercept. Cheap
telecommunications make censorship of phone calls and Inter-
net materials impractical. The main effect of the law, so far as
telecommunications is concerned, is a symbolic assurance that
the government is acting against Nitschke’s activities.
Nitschke runs workshops giving information about end-of-
life options (Fickling, 2004) throughout Australia and in New
Zealand and Britain and initiated North American workshops
in November 2009. After the passing of the Australian suicide-
information censorship law, Exit’s workshops in Australia are
run in two parts. In the first part, a public meeting that anyone
can attend, Nitschke gives general information. After this seg-
ment, anyone who wants to stay must become a member of
Exit and sign a waiver form intended to protect Exit from pros-
ecution. In the second part of the workshop, for members only,
Nitschke can give more detailed information, for example,
about purchasing Nembutal and constructing an exit bag.
Nitschke and his partner Fiona Stewart, a public health
sociologist, wrote a book titled The Peaceful Pill Handbook
giving detailed information about how to kill oneself (Nitschke
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Martin 57
& Stewart, 2006). It is freely available in most countries but
banned by the Australian government. However, it is easy to
buy a copy on the Internet directly from Exit International,
either in hard copy or an electronic version including photos
and video clips. In practice, the Australian law is not enforced
against individuals who buy copies, as long as they do not
publicize their law breaking. The ban affects libraries and
limits publicity in Australia. However, because the ban does
not effectively block access to the book, it could be consid-
ered to be a form of symbolic politics by which the Australian
government demonstrates that it is doing what it can against
In 2008, the Australian government announced it was plan-
ning to introduce mandatory filtering of the Internet. The
official reason was to block access to child pornography.
However, critics alleged that a side effect would be to block
access to many other types of sites—including on euthanasia.
The proposal triggered a firestorm of opposition. Because
the filtering was to be based on a list of Web addresses, crit-
ics said it would make little difference to the availability of
child pornography, which is usually distributed via unpub-
lished sites, peer-to-peer networks, or e-mail, sometimes
encrypted. More insidiously, the sites to be blocked by the
filter system were to remain secret, so members of the public
would not know what was being censored.
Implementation of this filtering system would put Australia
among a select group of countries with draconian Web cen-
sorship including Burma, China, Iran, and Saudi Arabia.
Most Australian Internet service providers refused to par-
ticipate in the government’s planned trial. A range of
anticensorship groups joined in campaigning, led by Elec-
tronic Frontiers Australia, whose membership jumped
dramatically because of this issue. The Australian online
activist group GetUp mounted a major campaign against
mandatory filtering.
Internet filtering was a threat to Exit’s operations, but
because it was a threat to so many other Internet users, the
antifiltering campaign mobilized a wide range of supporters.
In effect, the government, by casting its censorship net—in
this case also its Internet censorship—too widely, stimulated
the creation of a massive opposition that served to defend
Exit’s Internet presence.
Another tool used by Exit members is civil disobedience.
In 2002, 69-year-old Nancy Crick drank Nembutal and died.
She was surrounded by 21 family members, friends, and sup-
porters who could have been charged with assisting a suicide
and been sentenced to life imprisonment under the laws of
the state of Queensland. Crick’s case was widely known through
an Internet diary in which she wrote about her impending
death. There was safety in numbers: none of the 21 was charged.
Since then, Exit has set up a network called “Nancy’s
Friends” for advice, support, and ensuring no one need die
alone (Nitschke & Stewart, 2005).
6. People’s Research
Most research is done by professional scientists who studied
science at university and usually were apprenticed to senior
scientists through doctoral research. The variations from the
standard professional model are unusual and hence worth
In the 1980s and 1990s, after the emergence of AIDS, many
activists studied the science concerning the disease. Many of
them had little or no prior scientific training, yet they became
so highly expert in technical aspects directly relating to AIDS
that they could hold their own ground with leading experts in
the field and make credible interventions concerning research
priorities, treatment regimes, and the design of clinical trials
of AIDS drugs. This was an example of nonscientists achi-
eving in-depth understanding without becoming practicing
scientists (Epstein, 1996).
In Japan, in the 1970s, local teams of citizens—supported by
a few scientists—formed to investigate the cause of Minamata
disease. They investigated the history of the disease, inter-
viewed sufferers, and took measurements of plants and were
able to identify the cause, mercury poisoning from industry,
when large teams of scientists with plenty of money did not
(Ui, 1977).
Since then, citizen investigators have tackled many prob-
lems, most commonly local environmental issues (Community
Research Network, 2009). They are not professional scientists
but often they have some scientific training, typically acquired
through undergraduate study or practical experience. They
tend to investigate locally significant issues ignored by pro-
fessional scientists, sometimes because industry funding
discourages research that might threaten industry interests.
In some fields such as astronomy and botany, there is a
long tradition of amateur involvement in research. Lower
cost technology and easy access to information is making it
possible for amateurs to make discoveries (Ferris, 2003).
Exit’s search for methods of peaceful death fits into this
tradition of amateur and citizen research. Some Exit mem-
bers are trained scientists, but not with specific expertise in
end-of-life technologies. Exit’s research is highly focused: It
could be called goal-directed. It is not about knowledge for
knowledge’s sake.
Exit’s research organization is analogous to that in many
research laboratories. There is a research director—Nitschke,
who actually does a lot of the research himself—and many
investigators under his supervision. Rather than being held
together by money and careers, like conventional science,
Exit’s research is driven by commitment to a common cause.
Exit’s research, like other technological endeavors, con-
tains both technical and social dimensions. It includes methods
of access to existing technology, such as how to identify and
purchase drugs such as Nembutal. It contains information on
using technology, such as how much Nembutal is lethal and
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58 Bulletin of Science, Technology & Society 30(1)
what to expect when taking it. It contains information on
constructing technology, such as putting together an exit bag.
And it contains information about politics and law, such as
how to avoid being charged with murder for assisting suicide.
7. Conclusion
Technology has played an ever increasing role in the eutha-
nasia issue. Advances in medical technology have made it
more likely that the final stages of life will be both extended
and dependent on medical intervention in ways that are,
for some, filled with physical and mental suffering. Paral-
lel advances in palliative care have reduced the level of
suffering for many, including by slow euthanasia under the
supervision of medical professionals. At the same time, tech-
nological options for a peaceful death under one’s own
control are available but restricted by governments opposed
to euthanasia.
In response to these dilemmas, a citizen-based self-help
movement developed in Australia, resulting from Philip
Nitschke’s experiences with the short-lived period of legal
euthanasia in the Northern Territory, leading to the creation
of Exit International and the search for the peaceful pill,
namely, a self-administered technological aid for dying with
The Australian federal parliament’s intervention to over-
rule the Northern Territory euthanasia law inadvertently
triggered Nitschke to pursue a self-help trajectory. This has
led, curiously, to an escalating technology struggle between
Exit and its government-supported opponents, involving the
Australian government imposing increasingly stringent con-
trols over information that Exit has circumvented by using
the flexible features of telecommunications technology.
Australian government attempts to censor Exit may actually
have the impact of spreading information about do-it-yourself
euthanasia more widely. Exit’s investigations have become
ever more probing into ways of getting around harsh laws,
especially censorship. This has led Exit increasingly away
from the legal road espoused by most voluntary euthanasia
organizations in Australia and other countries. Critics of the
technology path raise concerns that removing legal or medi-
cal oversight of dying may increase the risk of mistakes and
abuses and reduce the prospects for law reform (Syme, 2008;
Werth, 2001).
Exit is searching for information about methods that use
ordinary materials to enable a peaceful death. Given that a
large majority of people in Australia and many other coun-
tries support voluntary euthanasia, Exit’s findings will have
a ready and expanding audience.
What is the future for euthanasia? For simplicity, it’s
convenient to describe three possible future paths. Path 1 is
continuation of laws that ban euthanasia, so most instances
remain covert, as at present. Path 2 is legalization—formal
or tacit—following the examples of the Netherlands, Belgium,
Oregon, Washington, and Switzerland. Path 3 is the spread of
knowledge and skills for easy techniques for peaceful death.
This is Exit’s path.
Exit’s approach sidesteps two types of controls: Path
1’s legal controls and Path 2’s medical controls. If the
push for access to euthanasia is seen as a social movement
(McInerney, 2000), then Exit may be serving as a “radical
flank” (Haines, 1984): an approach seen as radical even by
the mainstream movement. As such, it may provide a greater
incentive for legalization or better provision of hospice. Or,
in the spirit of self-help movements in various fields, including
the open-access and open-source movements, the search
for technological means to peaceful death may become the
main path.
I thank Jan Kent, Roger Magnusson, Philip Nitschke, Fiona
Stewart, Rodney Syme, Geoff Turner, and Nickolas Vakas for
helpful comments and suggestions.
Declaration of Conflicting Interests
The author joined Exit International in order to attend the members-
only portion of one of Philip Nitschke’s workshops but otherwise
has no conflicts of interest with respect to the authorship and/or
publication of this article.
The author received no financial support for the research and/or
authorship of this article.
Colby, W. H. (2006). Unplugged: Reclaiming our right to die in
America. New York: Amacom.
Community Research Network. (2009). Retrieved November 2,
2009, from
Dowbiggin, I. (2005). A concise history of euthanasia: Life, death,
god, and medicine. Lanham, MD: Rowman & Littlefield.
Epstein, S. (1996). Impure science: AIDS, activism, and the politics
of knowledge. Berkeley: University of California Press.
Ferris, T. (2003). Seeing in the dark: How amateur astronomers
are discovering the wonders of the universe. New York: Simon
& Schuster.
Fickling, D. (2004). A happy ending? Lancet, 364, 831.
Haines, H. H. (1984). Black radicalization and the funding of civil
rights: 1957-1970. Social Problems, 32, 31-43.
Kissane, D. W., Street, A., & Nitschke, P. (1998). Seven deaths in
Darwin: Case studies under the Rights of the Terminally Ill Act,
Northern Territory, Australia. Lancet, 352, 1097-1102.
Magnusson, R. S. (2002). Angels of death: Exploring the euthanasia
underground. Melbourne, Australia: Melbourne University Press.
McInerney, F. (2000). “Requested death”: A new social movement.
Social Science & Medicine, 50, 137-154.
Nitschke, P., & Stewart, F. (2005). Killing me softly. Melbourne,
Australia: Penguin.
at University of Wollongong on February 22, 2010 http://bst.sagepub.comDownloaded from
Martin 59
Nitschke, P., & Stewart, F. (2006). The peaceful pill handbook.
Lake Tahoe, NV: Exit International.
Nuland, S. B. (1993). How we die: Reflections on life’s final chap-
ter. New York: Random House.
Ogden, R. D. (2001). Non-physician assisted suicide: The techno-
logical imperative of the deathing counterculture. Death Studies,
25, 387-401.
Ryan, C. J., & Kaye, M. (1996). Euthanasia in Australia: The Northern
Territory Rights of the Terminally Ill Act. New England Journal
of Medicine, 334, 326-328.
Syme, R. (2008). A good death: An argument for voluntary eutha-
nasia. Melbourne, Australia: Melbourne University Press.
Ui, J. (1977). The interdisciplinary study of environmental prob-
lems. Kogai: The Newsletter from Polluted Japan, 5, 12-24.
Werth, Jr., J. L. (2001). Policy and psychosocial considerations
associated with non-physician assisted suicide: A commentary
on Ogden. Death Studies, 25, 403-411.
Yount, L. (2007). Right to die and euthanasia (2nd ed.). New York:
Facts on File.
Brian Martin has a PhD in theoretical physics from Sydney
University and is professor of social sciences at the University of
Wollongong. He is the author of 12 books and hundreds of articles
on scientific controversies, nonviolence, dissent, information issues,
and other topics.
at University of Wollongong on February 22, 2010 http://bst.sagepub.comDownloaded from
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ON May 25, 1995, the parliament of Australia’s North- ern Territory passed the Northern Territory Rights of the Terminally Ill Act,1 making voluntary euthanasia legal. This act allows physicians to prescribe and administer lethal substances to terminally ill patients who formally request assistance in ending their lives. In this article we provide an overview and analysis of the act, which is expected to take effect this year.
Reviewed by Jim Gleason, heart recipient 1. Surgeons view of death from personal, physical and emotional views 2. Even if you don't read all of the various death descriptions, be sure to read the final two chapters, The Lessons Learned and Epilogue to see what he summarizes from all the details provided in the earlier chapters 3. Lot said about extending life beyond what is reasonable, due to drs wanting to solve the Riddle 4. Interesting seeing his views and contrasting them with his actions when it came to his own brother dying of cancer – admits a mistake, very human 5. eloquent writing, well read and quoted 6. 1994 National Book Award nonfiction winner, Yale physician Nuland's study of the clinical, biological and emotional details of dying was a 14-week PW bestseller. In the same year as my own heart transplant, an amazing book was published titled: How We Die. I only coincidently "discovered " this book twelve years later and was fascinated in its reading, especially from the perspective of one who was still alive due to the gift of a donated heart and at 62 years of age, am now again looking to the future where my own mortality gets more interesting with each passing year of living this very fulfilled life post transplant. Let me say up front that nowhere in this book is the organ transplant subject or words mentioned. By the time you finish reading this amazing book, you will change the way you view your own mortality and how you expect to die and face that final moment.
A neglected topic in social movement theory is the effect of factionalism within movements, particularly the role of “radical” activists in shaping responses to “moderates.” This paper investigates the effect of black radicalization during the 1960s on the ability of moderate civil rights organizations to attract financial contributions from outside supporters. Trends in donations to seven major black organizations are analyzed. It is concluded that the activities of relatively radical black organizations, along with the urban riots, stimulated increased financial support by white groups of more moderate black organizations, especially during the late 1960s. This finding partially contradicts the widely-held belief that black militants only brought on a white “backlash.” On the contrary, the task of fundraising by moderate civil rights organizations was apparently made easier, not more difficult, by the racial turmoil of the 1960s.
Roger Magnusson’s angels of death describes the practice of extralegal assisted suicide and euthanasia by physicians, nurses, technicians, and other health care professionals who provide care to seriously ill patients and patients with AIDS who are dying. It is based on a snowball sample of 49 detailed interviews carried out over a period of three years with health professionals specializing in the care of patients with the human immunodeficiency virus and AIDS, principally in Sydney and Melbourne, Australia, and in San Francisco. This book is about cooperative euthanasia — that is, physician-assisted suicide and euthanasia occurring underground, mainly among patients with AIDS at home and those in large, tertiary-care hospitals in the United States and Australia. It describes networking among sympathetic physicians, nurses, and other health care workers and traces patterns of referral. It portrays ways in which health care professionals provide advice about drugs, assistance to those who wish to obtain drugs (often from an underground pharmacy), and informal psychiatric assessments. It also describes how they manipulate hospital procedures, fabricate information when signing death certificates, and collaborate with funeral directors in the orchestration and general facilitation of assisted dying at the bedside. It describes ways they may support both the patient and the family as well as debrief the family after a death.
During the 9 months between July, 1996, and March, 1997, the provision of euthanasia for the terminally ill was legal in the Northern Territory of Australia. Seven patients made formal use of the Rights of the Terminally Ill (ROTI) Act; four died under the Act. We report their clinical details and the decision-making process required by the Act. We taped in-depth interviews with the general practitioner who provided euthanasia. Further information was available from public texts created by patients, the media, and the coroner. All seven patients had cancer, most at advanced stages. Three were socially isolated. Symptoms of depression were common. Having met criteria of the Act, some patients deferred their decision for a time before proceeding with euthanasia. Medical opinions about the terminal nature of illness differed. Provision of opinions about the terminal nature of illness and the mental health of the patient, as required by the ROTI Act, created problematic gatekeeping roles for the doctors involved.
This paper addresses current developments in the right-to-die arena. While discussion of this area has traditionally been the province of disciplines other than sociology, including philosophy and bioethics, this paper offers an alternative framework from which to consider the progressive interest in control and choice at life's end which has developed this century, principally in the Western world. Taking a largely socio-historical approach, this paper argues that issues such as euthanasia and physician-assisted suicide can be seen as forming part of an international social movement, which is dubbed 'the requested death movement'. The paper traces the chronology of the movement, placing its framing activities, the emergence of individual activists and events and its progressive mobilization, within a consideration of so-called 'new' social movements, which have emerged since the 1960s. These are principally concerned with resisting state control of cultural matters, while reclaiming matters of identity, privacy and individual corporeality, which it is argued are at the core of the requested death movement. It is posited that this consideration can contribute to understandings of both the contemporary social organization of death and dying, and social movement theory more generally.
The report by Russel Ogden (2001) on a conference where devices designed to facilitate death were displayed and discussed highlights how far some individuals will go if they are committed to helping suffering people die. In this commentary, the author discusses the federal policy developments that have contributed to this movement and then expresses his concerns about using lay people to provide assistance with hastening death.