“I think (technology) is important to democratize and demedicalize the process,” Nitschke says, adding that Sarco does not rely on highly restricted medications to function. “So all of those issues are ways to make the process more equitable.”
In Switzerland, where Sarco was used, Nitschke’s arguments about access to assisted suicide are not particularly radical. Residents and visitors can now access assisted suicide even if they are not terminally ill. But in the Netherlands, Nitschke’s adopted country, Sarco reflects an ongoing debate about the place of assisted suicide 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 ease the doctor’s burden. “I’m passionate about a person’s right to have access to help in dying, but I don’t see why they should make me a murderer,” says Nitschke, who earned his medical degree in 1989.
Theo Boer, who spent nine years evaluating thousands of assisted suicide cases on behalf of the Dutch government, disagrees that gatekeepers are a bad thing. “We can’t leave this in the hands of the market,” he says, “because it’s dangerous.” However, he is more sympathetic to Nitschke’s argument that doctors should not bear the emotional stress in countries where assisted suicide is legal. “Although what it does is strange, it contributes to the much-needed debate in the Netherlands about whether or not we need this strong involvement of doctors,” says Boer, who is now a professor of healthcare ethics at the Theological University of Groningen.
“We cannot burden the doctor with the responsibility of solving all our problems.”
For three decades, Nitschke has been a firebrand 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 that Sarco will ever be normalized, but believes that Nitschke’s creation, even if it seems irresponsible to some, raises important questions. “It’s trying to catalyze a perhaps difficult conversation about people’s right to access suicidal technologies,” he says.
Nitschke, now 77, first explored the idea of delegating machine-assisted suicide in the 1990s. After Australia’s Northern Territory became the first To legalize the process, Nitschke was worried about the risk that people would see him or his colleagues as “an evil doctor giving lethal injections to a dying patient who didn’t know what was happening,” he says.